HELLP syndrome is an emergency-seeking medical condition during pregnancy. Learn about the symptoms, risks, diagnosis and treatment of HELLP syndrome.
Last Updated: Oct 22, 2020 11:29 GMT
HELLP syndrome is an emergency-seeking medical condition during pregnancy which affects, on an average of 7 in 1000 pregnancies. 10-20% of HELLP syndrome cases are closely associated with severe preeclampsia during pregnancy.
What is HELLP syndrome?
HELLP syndrome is not a disorder by itself, rather a condition characterized by a set of symptoms. HELLP is an abbreviation of the triad signs that are characteristic of the condition, namely, Hemolysis, Elevated liver enzymes, Low Platelet count.
Hemolysis, the breaking down of red blood cells is the major complication of HELLP syndrome. It results in low hemoglobin levels and increases in the secretion of liver enzymes.
Elevation of liver enzymes refers to the rise in LDH which is a direct effect of hemolysis. The number of liver enzymes, AST and ALAT, could elevate because of a liver injury.
Low Platelet count or thrombocytopenia is another high-risk symptom of HELLP syndrome. Platelets are important in blood clotting and a decrease in their count during pregnancy can pose a serious risk to the baby and the mother.
What are the symptoms of HELLP syndrome?
Common symptoms of HELLP syndrome can overlap with normal pregnancy symptoms such as the ones listed below:
- Nausea and vomiting
In addition, in a few days, more specific symptoms may arise, including:
- Pain in the abdomen, specifically on the right side (where the liver is located)
- General flu-like symptoms
- High blood pressure
- Changes in vision
- Jaundice-like symptoms (yellowing of the eyes)
- Increased susceptibility to bleeding after cuts
How does HELLP syndrome affect the mother and the baby?
If early intervention is not involved, HELLP syndrome can be threatening to both the mother and the baby. Maternal death has been reported in 1% of HELLP syndrome cases and infant death or complication in 7 to 34% of the cases.
Major complications for pregnant mothers with HELLP syndrome are:
- Placental Abruption – breaking apart of the placenta from the uterine wall during pregnancy.
- Blood clotting disorder leading to bleeding problems
- Kidney failure
- Accumulation of fluid in the lungs, abdomen or brain
- Liver injury, damage or rupture
- Retinal detachment – retina detaches from the tissue layer underneath
Babies born to mothers affected with HELLP syndrome are at higher risk of premature birth (before 28 weeks) resulting in
- Intrauterine growth restriction (IUGR)
- Low birth weight
- Neonatal respiratory distress syndrome (Neonatal RDS) – complications in newborn breathing because of underdeveloped lungs.
How is HELLP syndrome diagnosed?
HELLP symptoms can easily be confused with symptoms of preeclampsia. Diagnostic tests for HELLP syndrome, however, can clearly distinguish the two. Common diagnoses for HELLP include:
- Physical examination for tenderness in the right abdomen region
- Measurement of high blood pressure
- Urine test which confirms the presence of high levels of protein in the urine
- Blood tests which report low levels of red blood cells, platelet count and hemoglobin and high levels of liver enzymes
How is HELLP syndrome treated?
The best possible remedy for HELLP syndrome is to take the baby out at the earliest. Proceeding the pregnancy with HELLP can be dangerous to both the mother and the baby. However, if a baby is less than 34 weeks or if HELLP symptoms have been worsening, it is recommended to use medications such as corticosteroid to help baby’s lungs to mature before taking the baby out. Also, medications to prevent seizures and combat high blood pressure may be advised.References
Haram, K., Svendsen, E., & Abildgaard, U. (2009). The HELLP syndrome: clinical issues and management. A Review. BMC pregnancy and childbirth, 9, 8.
APA. HELLP Syndrome. American Pregnancy Association.
Ertan, A., Wagner, S., Hendrik, H., et al. (2005). Clinical and biophysical aspects of HELLP-syndrome. Journal of Perinatal Medicine, 30(6), pp. 483-489.