HELLP Syndrome
Definition
HELLP syndrome is a rare but serious condition (a form of preeclampsia ) that occurs during pregnancy or just after delivery. HELLP stands for:
- H emolysis
- E levated
- L iver enzymes (showing liver damage)
- L ow P latelet count
HELLP involves three types of problems:
- Hemolysis—(the destruction of red blood cells) can lead to anemia (low red blood cells) and feeling tired.
- High liver enzymes—liver enzymes are chemicals in the blood that show how well the liver is working. High levels of enzymes mean the liver has been damaged.
- Low platelet count—since platelets are cells that help bleeding stop, a low level of platelets can lead to problems with bleeding too long.
Red Blood Cells
The Liver
Causes
The causes of HELLP syndrome are unknown. The syndrome occurs in about 4 of every 1,000 pregnancies.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Most women who get HELLP have blood pressure problems before HELLP develops.
Risk factors for HELLP syndrome:
- Age: over 25
- Race: White
- Two or more previous deliveries
- Serious problem with a previous pregnancy
- Preeclampsia or HELLP in a previous pregnancy
Symptoms
Some women may have no symptoms at all.
Symptoms of HELLP syndrome:
- Feeling tired
- Pain in your upper right abdomen
- Bad headaches
- Nausea
- Vomiting
- Black spots in your vision
Diagnosis
Your doctor will ask about your symptoms and medical history, and perform a physical exam. You may need to be referred to a doctor who specializes in obstetrics.
Tests may include:
- Complete blood count—a blood test that checks the number of red blood cells and platelets, two types of blood cells that are low in HELLP syndrome
- Liver function tests—a blood test that looks at how well your liver is working
Treatment
Your doctor may send you to a hospital that can provide special care for pregnant women.
Treatment options include the following:
Delivery
The only cure for HELLP syndrome is delivery of your baby. If your case is not severe and you are 34 weeks pregnant or less, your doctor may recommend trying other treatments until you reach 34 weeks of pregnancy. These treatments include strict bed rest, a low-salt diet, and drinking a lot of fluids.
Medications
- Corticosteroids (to assist the fetal lungs to mature)
- Magnesium sulfate to prevent seizures
- Blood pressure medications, if your blood pressure is high
In some cases of HELLP, transfusions of platelets or red blood cells are used to increase the number of these cells in the blood.
CANADIAN RESOURCES:
Sick Kids
http://www.sickkids.ca/
The Society of Obstetricians and Gynaecologists of Canada
http://sogc.medical.org/
References:
Diagnosis and Management of Preeclampsia and Eclampsia, American College of Obstetricians and Gynecologists, Practice Bulletin, No 33, January 2002
HELLP syndrome and your pregnancy. American Family Physician website. Available at: http//www.aafp.org/afp/990901ap/990901b.html. Accessed August 3, 2005.
Padden MO. HELLP syndrome: recognition and perinatal management. Am Fam Physician . 1999;60:829-36, 839.
Preeclampsia/high blood pressure. March of Dimes website. Available at: http://www.marchofdimes.com/printableArticles/188_1054.asp . Accessed August 3, 2005.
Last reviewed November 2008 by Jeff Andrews, MD, FRCSC, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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