What is HELLP Syndrome in Pregnancy?

HELLP syndrome in pregnancy, is a collection of signs and symptoms called syndrome, which characterize this serious and often deadly pregnancy complication.

This syndrome is an acronym for:
H --  hemolysis... which is the abnormal destruction and breakage of red blood  cells and release of hemoglobin into the serum

EL--  elevated liver enzymes

LP--  low platelets

There is an ongoing debate, amongst the experts, whether preeclampsia and HELLP Syndrome are interrelated or the relationship between the two.... what is not in doubt, is the fact that both of them, can be very severe and sometimes fatal.

Experts all agree, according to research, that as much as 17 percent of pregnant women, with HELLP syndrome, do not have high blood pressure or protein in the urine.

Also what is not in question is the fact that, HELLP syndrome in pregnancy is connected to severe and serious liver problems, including bleeding in the liver and liver rupture.

Pregnant ladies with severe Pre eclampsia may also have similar symptoms as that of the HELLP syndrome

There are at least six (6) Reasons why Preeclampsia and HELLP Syndrome survivors should not blame themselves… discover the reasons here

Causes of HELLP Syndrome Pregnancy

 The exact causes of HELLP syndrome pregnancy is not fully understood. Researchers believe that, this pregnancy complication may be as result of abnormal placental formation and function. Also there is more pronounced coagulation disorder and liver inflammation.

Coagulation is when the liquid blood is slightly converted to semi solid lumps or clots...creating a host of other problems.

There are other factors being considered as the cause of HELLP, including Acute Fatty Liver of Pregnancy

 HELLP Syndrome in Pregnancy Statistics

HELLP Syndrome in pregnancy is fairly rare. But when it occurs... it is usually very severe.

According to World Health Organization (WHO)...""HELLP Syndrome occur in 10  -  20 percent of women with Severe Pre eclampsia, and it is associated with substantial  widespread of endothelial damage""

HELLP Risk factors

  • pregnant women whose mother had the disease, has a chance of developing this problem
  • if your sister has this problem
  • if you previously had preeclampsia or HELLP Syndrome in previous pregnancy, you may develop this problem again
  • most people affected by this pregnancy complication has one or more children before.

 Signs and Symptoms of HELLP Syndrome in Pregnancy

 Symptoms and signs of HELLP usually develop between 28   to 36 weeks of pregnancy ...but can develop anytime.

  • High blood pressure
  •  Abdominal pain...with nausea and vomiting, which may be mistaken for a gastroenteritis, viral illness, gall bladder problems, appendicitis or acute fatty liver of pregnancy... which may delay appropriate and  proper treatment and this can be fatal..... 
  • Bleeding
  • Jaundice
  • Sudden facial and hands swelling during pregnancy
  • Proteinuria   

Other HELLP Syndrome Symptoms includes:


  • Low platelets count
  • Hemolysis
  • Anemia
  • Malaise
  • Disseminated intravascular coagulopathy
  • Headaches during pregnancy... and not responding to analgesics
  • ASCITES.....!!!

HOW IS HELLP  DIAGNOSED?

   Usually the diagnosis of HELLP is confirmed with the blood tests comprising of it acronym:

H----  Hemolysis

EL---  Elevated liver enzymes

LP---  Low platelets count

The pregnancy doctor / Maternal Fetal Medicine Specialist will do all the necessary tests to confirm this diagnosis.

 Treatment of HELLP Syndrome of Pregnancy

Since every case is very unique, with so many variables of signs, symptoms, family history, stage of pregnancy etc.... the treatment is usually personalized for individual cases.

The treatment and management is usually under the care of the highly trained, experienced and skilled obstetrician  gynecologist / pregnancy doctor / Maternal Fetal Medicine Specialist who will plan and have direct management and care of this pregnant woman.

Most of the Management involves making sure, the pregnant woman and the baby (fetus) is stabilized and decide when quick delivery of the baby is warranted, complete bed rest may be part of the treatment.

Usually the pregnant woman will be admitted to the Intensive Care Unit for close observation, treatment, and monitoring of the mother-to-be and the fetus.

Medications used by the medical doctors may include:

ECULIZUMAB....   an inhibitor that targets complement protein C5

Labetalol , Nifedipine, Hydralazine, etc., for high blood pressure

Use of Corticosteroids

Blood transfusion, or administration of blood products.

Other medications to prevent seizures (convulsions) like Magnesium Sulphate.

 Complications

  • Disseminated intravascular coagulation
  • Pulmonary edema
  • Abruptio  placentae
  • Liver damage
  • Retinal detachment           

Because there is no way to prevent this condition at the moment, please ensure you attend your prenatal / antenatal appointments as arranged.

Watch out for its signs and symptoms and seek medical help without any delay, if and when you need it... or when you noticed something is not going as expected.

 In conclusion, as deadly and life threatening HELLP Syndrome in Pregnancy may be.... most deaths and fatalities can be avoided, when the problem is diagnosed early, and appropriate and proper treatment and management is started.

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