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What is HELLP syndrome ?

HELLP syndrome is term used to describe a condition wherein a group of signs occur in pregnant women and who experience:

  • H- Hemolysis, i.e. Red blood cells breakdown
  • EL- Elevated levels of liver enzymes
  • LP- Low platelet count

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Symptoms of HELLP syndrome

Women with HELLP syndrome often look normal and the early symptoms of the condition can include:

  • Epigastric pain or a feeling of heart burn in around ninety percent of the cases
  • Malaise or feeling ill in around ninety percent of the cases
  • Jaundice
  • Hepatomegaly
  • Fluid retention and gaining weight
  • Headache in around thirty percent of the cases
  • Arterial hypertension
  • Fatigue or weakness
  • Nausea and vomiting that keeps on getting worse with the passage of time. This is true for fifty percent of the cases of HELLP syndrome
  • Blurry vision
  • In rare cases, there may be nosebleeds or other bleeding which do not stop easily
  • Seizures or convulsions, which are also  rare
  • Feeling pain in the upper right part of abdomen

The following complications may develop, before and after the baby is born. Possible complications of HELLP syndrome may include:

  • Formation of fluid in lungs or pulmonary edema
  • Kidney failure
  • Liver hemorrhage and followed by failure
  • Disseminated intravascular coagulation (DIC), which is a blood clotting condition that may lead to excess bleeding or blood hemorrhage
  • Detachment of placenta from the wall of uterine or placental abruption
  • Retinal detachment and other eye problems are also reported
  • Transient diabetes insipidus can follow HELLP syndrome

Once the child is born, the symptoms of HELLP syndrome will improve in due course of time, and most of the complications will get cured.

When to consult a doctor:

If the symptoms of HELLP syndrome occur during the pregnancy, you need to:

  • Consult obstetrician immediately
  • Can call local emergency number (such as 911)
  • Visit emergency room

As there are no known ways to avoid the HELLP syndrome, all prospective mothers need to take all the preventive prenatal care very early. It has to be continued throughout the pregnancy period. An early diagnosis and detection of HELLP syndrome will make it easier for the doctor to treat the pregnant mother. Additionally, it can help the patient to prevent complications and can pave the path for easy recovery.

Examinations and tests for HELLP syndrome

While conducting the physical examination, the medical practitioner may find:

  • Enlarged liver
  • High Blood pressure
  • Swelling in legs
  • Tenderness of abdomen, particularly in the right upper side

Liver enzymes may be on higher side. The counts of platelets may be low. CT scan may indicate bleeding in liver.

Tests to know about the health of the baby also will be done.

Causes of HELLP syndrome

  • The cause for HELLP syndrome is not known.
  • Out of one thousand pregnancies, HELLP syndrome occurs in 1 or 2 pregnancies. Ten to twenty percent of pregnant women are found with severe preeclampsia or eclampsia.
  • HELLP syndrome generally tends to develop before the 37th week of pregnancy. On occasions, the condition may develop one week after delivery of the baby.

Many pregnant ladies may have high blood pressure and preeclampsia, even before they develop HELLP syndrome. In few cases HELLP syndrome precedes preeclampsia, and this may be often misdiagnosed as:

  • Gallbladder disease
  • Hepatitis
  • Flu or viral attack
  • Lupus flare
  • Thrombotic thrombocytopenic purpura
  • Idiopathic thrombocytopenic purpura (ITP)

Treatment for HELLP syndrome

The best possible treatment for HELLP syndrome is the delivery of the baby as early as possible. This is because of the fact that, if the symptoms of HELLP syndrome and liver abnormalities associated with it become worse, then it may cause undue harm to the baby as well as the mother.

The doctor may give drugs to induce the labor, or may go for a C-section.

The mother may receive the following treatments:

  • A blood transfusion, if the problem of bleeding is severe
  • For faster development of lungs for the baby, doctor may prescribe corticosteroid medications.
  • Medications for may be given to control high blood pressure.

Surgery: Pregnant women with severe liver damage may require liver transplantation.

Prognosis of HELLP syndrome

  • Any delay in the treatment of HELLP syndrome and its symptoms in the early stages can result in the development of serious complications for one out of four affected women, during the later stages. Delay in effective detection and treatment in the early stage can also result in the death of the affected women, in some cases.
  • The rate of death for newborn babies, born to mothers affected by HELLP syndrome, depends on the baby’s weight at birth and the baby’s organ developments, particularly the lungs.

HELLP syndrome may return in future pregnancies at the rate of one in four pregnant women.

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