HELLP syndrome is a type of extreme preeclampsia. Preeclampsia is a complication of pregnancy characterized by elevated blood pressure.
According to an older study from 2009, HELLP syndrome occurs in 0.5–0.9 per cent of all pregnancies and in 10–20 percent of women with serious preeclampsia.
This usually happens during the final 3 months of pregnancy, or shortly after birth. Symptoms include nausea and vomiting, stomach pain and headache.
In both the pregnant woman and the baby, untreated HELLP syndrome may easily become life-threatening. However the condition is rarely fatal with treatment.
In this post, we list the HELLP syndrome signs and symptoms and describe the risk factors, complications and treatment options in detail.
What is it?
HELLP syndrome is a result of a uncommon, life-threatening pregnancy. It’s causing blood, liver and blood pressure issues.
In 1982 Dr. Louis Weinstein named the disorder on the basis of the problems it causes. The name signifies:
- H — hemolysis, which is the breakdown of red blood cells
- EL — elevated liver enzymes
- LP — low platelet count
HELLP syndrome usually develops during or shortly after the later stages of pregnancy.
Approximately 70 percent of cases develop prior to delivery, typically between weeks 27 and 37 of pregnancy, according to older studies. The remaining cases happen within 48 hours of delivery.
Diagnosing HELLP syndrome can be difficult for physicians, since the signs mimic those of many other disorders.
The syndrome may cause both the pregnant woman and the developing fetus to have complications. This can be fatal without treatment.
HELLP syndrome vs. preeclampsia
HELLP syndrome and preeclampsia are related. Preeclampsia is another complication of pregnancy which often leads to high blood pressure and organ damage, especially to the liver and kidneys.
Usually Preeclampsia occurs after 20 weeks of pregnancy. As with the HELLP syndrome, if left untreated, preeclampsia can cause life-threatening complications.
Some doctors think HELLP syndrome is a severe type of preeclampsia.
Symptoms
HELLP symptoms may be close to those of many other conditions like preeclampsia.
Symptoms include:
- changes in vision
- fatigue
- headache
- indigestion
- malaise
- nausea and vomiting
- pain when breathing deeply
- shoulder pain
- sudden weight gain
- swelling of the hands, legs, or face
- tenderness or pain in the upper right stomach
Rarely, people with HELLP syndrome may experience confusion and seizures.
Signs a doctor will check for to indicate HELLP syndrome include:
- high blood pressure
- protein in the urine
Risk factors
It is unclear what exactly causes HELLP syndrome. Some factors however increase the risk of a person having the disorder. These risk factors encompass:
- having preeclampsia
- having a history of preeclampsia or HELLP syndrome
- being older than 25
- being Caucasian
- having obesity
- having given birth two or more times previously
- having diabetes, kidney disease, or high blood pressure
Diagnosis
A doctor can diagnose HELLP syndrome based on a physical examination and checking for blood and urine.
The doctor will look for signs of:
- high blood pressure
- an enlarged liver
- swelling in the face, hands, or legs
- abnormal liver function
- abnormal blood platelet count
Often, the doctor may order an imaging scan to check bleeding in the liver.
Doctors also find diagnosing HELLP syndrome difficult. This is especially true when the urine does not display signs of high blood pressure or protein.
A physician can mistake gastritis, gallbladder disease, or flu symptoms.
Where a physician diagnoses HELLP syndrome they can identify it as:
- class I: severe thrombocytopenia (platelets under 50,000 cubic millimeters (mm3))
- class II: moderate thrombocytopenia (platelets between 50,000 and 100,000/mm3)
- class III: mild thrombocytopenia (platelets between 100,000 and 150,000/mm3)
Treatment
Baby delivery is the most normal and the most effective treatment for people with HELLP syndrome.
Early baby delivery is also less dangerous than continuing a pregnancy with HELLP syndrome.
Doctors would typically consider delivering the baby after week 34 of the pregnancy if serious preeclampsia or HELLP syndrome occurs.
A doctor may deliver the baby before this, if the fetus or mother’s health deteriorates.
Other treatments likely needed include:
- a blood transfusion to increase low platelet count
- corticosteroids to help the baby’s lungs mature
- medication for high blood pressure or seizure prevention
Complications
HELLP syndrome can cause significant complications for both mother and baby, including:
- liver rupture
- placental abruption
- seizures
- stroke
Placental abruption occurs when placenta is separated from wall of the uterus. It occurs before the baby is born, which may lead to premature birth or death.
The long-term outlook for women with HELLP syndrome is strong, but serious complications are fairly common.
The outlook for the fetus or neonate depends on delivery age and birth weight. The average chance of death is 7–20 percent for the fetus or newborn.
Babies who are born early can have complications too. The Preeclampsia Foundation reports that babies weighing at least 2 pounds (lb) have the same survival rate and outlook as babies of the same age that are not HELLP.
If the baby weights less than 2 lb at birth, longer periods of hospitalization and ventilator care are more likely to be needed.
Chance of recurrence
In potential births, having a history of HELLP syndrome raises the likelihood of preeclampsia or HELLP syndrome.
One research indicates that the incidence of such conditions is approximately 18% in potential pregnancies.
Although HELLP syndrome can not be prevented, a person can decrease the likelihood of developing serious complications during pregnancy by:
- losing weight before getting pregnant, if overweight
- attending all prenatal appointments during pregnancy
- understanding the signs and symptoms of HELLP syndrome and preeclampsia
- providing healthcare professionals with a full medical history, including previous pregnancy complications and a family history of pregnancy complications
- seeking help immediately if symptoms develop
HELLP syndrome describes a uncommon but severe pregnancy complication. Most women with the disorder should recuperate with medication.
HELLP syndrome can cause severe and life-threatening complications without treatment.
Treatment for HELLP syndrome usually involves delivering the infant, particularly if the condition occurs after the 34th week of pregnancy, or if the mother or fetus ‘health is declining.
People who have questions about preeclampsia, HELLP syndrome or other risks of pregnancy should talk to their doctor. Someone displaying signs and symptoms of HELLP syndrome will seek medical attention immediately. HELLP syndrome:
