Reduced pseudocholinesterase activity in patients with HELLP syndrome

Samuel Lurie*, Oscar Sadan, Galia Oron, Asora Fux, Mona Boaz, Tiberiu Ezri, Abraham Golan, Jacob Bar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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.

Original languageEnglish
Pages (from-to)192-196
Number of pages5
JournalReproductive Sciences
Issue number2
StatePublished - Feb 2007


  • HELLP syndrome
  • Obstetric anesthesia
  • Pseudocholinesterase
  • Severe preeclampsia


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