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Reduced Pseudocholinesterase Activity in Patients With HELLP Syndrome

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Abstract

The authors previously reported a case of decreased pseudocholinesterase activity in a patient with HELLP syndrome. It was assumed that the reduced pseudocholinesterase activity in HELLP syndrome is associated with impaired liver function. The present study assesses the prevalence of low pseudocholinesterase in patients with HELLP syndrome. Serum pseudocholinesterase activity was determined with spectrophotometer in 15 patients with HELLP syndrome. Two control groups matched for gestational age were recruited: 15 healthy women with uncomplicated pregnancy and 15 women with severe preeclampsia without HELLP. The prevalence of reduced pseudocholinesterase activity lower than normal limit was 60.0% (9/15) in patients with HELLP syndrome, 33.3% (5/15) in patients with severe preeclampsia, and 6.6% (1/15) in women with normal pregnancy, respectively (P =.009). The pseudocholinesterase activity was found to correlate with serum alanine aminotransferase levels (r = 0.417, P =.006) and with serum aspartate aminotransferase levels (r = 0.462, P =.002). Considering the increased prevalence of reduced pseudocholinesterase activity in patients with HELLP syndrome, the authors suggest that whenever general anesthesia is applied in these patients, the anesthesiologist should be aware that the patient may show slow metabolic degradation of choline-ester drugs.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel

    Samuel Lurie MD, Oscar Sadan MD & Abraham Golan MD, FRCOG

  2. Department of Biochemistry, Edith Wolfson Medical Center, Holon, Israel

    Asora Fux PhD

  3. Epidemiology and Statistics Unit, Edith Wolfson Medical Center, Holon, Israel

    Mona Boaz PhD

  4. Department of Anesthesia, Edith Wolfson Medical Center, Holon, Israel

    Tiberiu Ezri MD

  5. Perinatal Division, Department of Obstetrics and Gynecology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel

    Galia Oron MD & Jacob Bar MD

  6. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Samuel Lurie MD, Oscar Sadan MD, Galia Oron MD, Mona Boaz PhD, Tiberiu Ezri MD, Abraham Golan MD, FRCOG & Jacob Bar MD

Authors
  1. Samuel Lurie MD
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  2. Oscar Sadan MD
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  3. Galia Oron MD
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  4. Asora Fux PhD
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  5. Mona Boaz PhD
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  6. Tiberiu Ezri MD
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  7. Abraham Golan MD, FRCOG
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  8. Jacob Bar MD
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Correspondence to Samuel Lurie MD.

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Lurie, S., Sadan, O., Oron, G. et al. Reduced Pseudocholinesterase Activity in Patients With HELLP Syndrome. Reprod. Sci. 14, 192–196 (2007). https://doi.org/10.1177/1933719107299871

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