What is HELLP Syndrome

HELLP syndrome is a severe complication of preeclampsia, a disorder of pregnancy that causes high blood pressure and other serious problems. In most cases, the syndrome develops before 35 weeks of pregnancy, but it can also develop right after childbirth.

The condition is life-threatening to both the mother and baby.

The letters in HELLP stand for these problems:

• H – Hemolytic anemia, hemolysis. This refers to the destruction of blood cells.
• EL – Elevated liver enzymes. This is a sign of liver damage.
• LP – Low platelet count. This refers to blood cells that help stop bleeding.

What are the causes?

The cause of this condition is not known.

What increases the risk?

You are more likely to develop this condition if:

• You are pregnant with more than one baby.
• You have other medical conditions, such as diabetes or an autoimmune disease.
• Any of these things happened during a previous pregnancy:
  • You had preeclampsia or eclampsia.
  • Your baby did not grow as expected.
  • Your baby was born prematurely.
  • Your placenta separated from your uterus (placental abruption).
  • You lost your baby (fetal death).

What are the signs or symptoms?

Symptoms of this condition include:

• Severe headache.
• Blurry or double vision.
• Pain in the upper right abdomen.
• Pain in the shoulder, neck, and upper body.
• Fatigue.
• Feeling sick.
• Seizures.
• Swelling of the hands, face, legs, and feet.
• Sudden weight gain.
• High blood pressure.

How is this diagnosed?

This condition may be diagnosed with blood and urine tests. These tests may include:

• A complete blood count.
• A liver function test.
• A kidney function test.
• A measurement of the salts and other chemicals in your body (electrolytes).
• A blood coagulation test.
• Measurement of protein in the urine.

You may also have other tests, including:

• Checking your blood pressure.
• Fetal ultrasound.
• Monitoring your baby’s heart rate.

How is this treated?

This condition is treated by delivering the baby as soon as possible. You may be given medicines to start contractions (induce labor) so that the baby can be delivered vaginally, or you may have a cesarean delivery. Additional treatment may include:

• Receiving an infusion of magnesium sulphate before delivery. Magnesium sulphate is a medicine that helps prevent seizures.
• Receiving medicines to lower and control blood pressure. These may be given if your blood pressure is too high.
• Receiving steroid hormones (corticosteroids) to help your baby’s lungs mature faster.

During your treatment, you and your baby will be monitored and your conditions will be managed.

How is this prevented?

If you are at risk for preeclampsia, your health care provider may recommend that you take one low-dose aspirin (a dose of 81 mg) each day during your pregnancy. This will help prevent high blood pressure. You may be at risk for preeclampsia if:

• You had preeclampsia or eclampsia during a previous pregnancy.
• Your baby did not grow as expected during a previous pregnancy.
• One of your children was born prematurely.
• You experienced a placental abruption during a previous pregnancy.
• You lost your baby during a previous pregnancy.
• You are pregnant with more than one baby.
• You have a medical condition, such as diabetes or an autoimmune disease.

Contact a health care provider if:

• You gain more weight than expected.
• You have headaches.
• You have nausea or vomiting.
• You have abdominal pain.
• You feel dizzy or light-headed.

Get help right away if:

• You have a seizure.
• You develop sudden or severe swelling anywhere in your body. This usually happens in the legs.
• You have changes in your ability to speak or move your body.

Summary

• HELLP syndrome is a severe complication of preeclampsia, a disorder of pregnancy that causes high blood pressure and other serious problems.
• In most cases, the syndrome develops before 35 weeks of pregnancy, but it can also develop right after childbirth. The condition is life-threatening to both the mother and baby.
• This condition is treated by delivering the baby as soon as possible. You may be given medicines to start contractions (induce labor) so that the baby can be delivered vaginally, or you may have a cesarean delivery.
• During your treatment, you and your baby will be monitored and your conditions will be managed.