HELLP Syndrome in Pregnancy

Unfortunately there is still an abundance of unanswered questions about HELLP Syndrome. Many experts believe it is a variant of preeclampsia, however, others feel it is completely separate. The only thing that everyone can agree on is that HELLP Syndrome is a series of symptoms that make up a syndrome that affects pregnant women. Studies show that HELLP Syndrome affects approximately 0.2-0.6 percent of all pregnancies. Not an alarming rate, however, HELLP Syndrome is a very serious condition that shouldn’t be taken lightly.

HELLP Syndrome stands for:

H- Hemolysis (breakdown of red blood cells)

EL- Elevated Liver Enzymes (liver function)

LP- Low Platelets Counts (platelets help the blood clot)

Many doctors and experts alike associate HELLP Syndrome with preeclampsia, however, there are many documented cases where HELLP Syndrome occurs without the diagnosis of preeclampsia. 4-12% of women who suffer from preeclampsia develop HELLP Syndrome. Sadly, misdiagnosis occurs more often than not due to the fact that many of the HELLP Syndrome symptoms are symptoms of other conditions. In fact, the symptoms can actually be the first sign of preeclampsia. Other conditions that lead to misdiagnosis due to the symptoms of HELLP Syndrome include:

Hepatitis
Gallbladder Disease
Idiopathic/Thrombotic Thrombocytopenic Purpura

HELLP Syndrome Symptoms

There are many symptoms of HELLP Syndrome that doctors try to look for. Some are more common than others, which often leads to the misdiagnosis of the condition.

Common symptoms include:

Headaches
Fatigue
Upper right abdominal pain/tenderness
Severe Nausea
Severe Vomiting

Other symptoms include:

Protein in urine
Bleeding
Vision changes, such as blurred vision
Edema (swelling)
Migraines
High Blood Pressure

Causes of HELLP Syndrome

Many experts are still unclear of the exact causes of the syndrome, however after many documented cases, many of the women have these factors in common:

Already diagnosed with preeclampsia
Already diagnosed with pregnancy induced hypertension
Previously diagnosed with HELLP Syndrome in prior pregnancies
Over the age of 25
Caucasian ethnicity
Multiparous (given birth two or more times)

HELLP Syndrome Treatment

The best way to stop HELLP Syndrome from continuing or worsening is by giving birth. Depending on where the expectant mother is in her pregnancy term will determine whether or not immediate delivery is an option. With pregnancies that are under 34 weeks gestation, doctors try to elevate lung function of the baby to see how well he or she would handle the delivery. If it is unsafe, or if a pregnancy is still too far away from the due date, treatment may include:

Best rest, either in the patient’s home or in the hospital, depending on the severity of the condition
Corticosteroid (helps baby’s lungs develop quicker)
Magnesium Sulfate (prevents seizures)
Blood pressure medication
Blood transfusion if platelet count is too low
Fetal monitoring and tests

Tests that may be performed on your baby may include biophysical tests, sonograms, non-stress tests, and fetal movement evaluations. The only other possible treatment is for women who are passed 34 weeks gestation, in which the c-section delivery method is usually recommended, especially if the expectant mother was given a TOL, or trial of labor previously without success.

HELLP Syndrome Prevention

Unfortunately, there isn’t any known prevention steps women can take since the causes of HELLP Syndrome are still unknown. Once experts figure out the actual cause(s) for the condition, prevention advice can be given. Early detection is the best way to ease the seriousness of the condition, however, with the large amount of cases that fall under late detection and misdiagnosis, it is often times too late. Many experts suggest that since HELLP Syndrome is related to preeclampsia, a proper diet, a regular exercise routine and healthy blood pressure doesn’t hurt.

HELLP Syndrome Risks and Complications

If this condition is left untreated, misdiagnosed for too long, or undiagnosed, it can result in life-threatening complications for both mom and baby. Some of the complications that can arise from HELLP Syndrome include:

Placental abruption
Blood transfusion
Pulmonary edema (a build up of fluids in the lungs)
Lung failure in mother
Acute renal failure
Lung failure in baby
Intrauterine Growth Restriction (IUGR)
Ruptured liver hematoma
Permanent liver damage
Death of mother
Death of baby

Depending on certain factors such as the severity of symptoms, gestation of pregnancy and the promptness of treatment, death can occur to both mother and baby. Infants have a great morbidity rate of 10-60%, while the maternal morbidity rate is only 1.1% of those diagnosed with HELLP Syndrome.

When to Call Your Doctor

If you haven’t been diagnosed with HELLP Syndrome, but have symptoms or are at risk for developing it, you should definitely call your doctor immediately to begin testing. Early detection yields the best results in the majority of cases of HELLP Syndrome, and since there are hardly any prevention or treatment methods available, early detection and close monitoring is the best way to help the condition until the pregnancy term is over.