Pre-eclampsia is a condition in which placental abnormalities cause serious complications for a pregnant woman, such as high blood pressure and leaky kidneys. Involvement of other organs distinguishes it from pregnancy-induced high blood pressure.…
What is HELLP syndrome?
HELLP syndrome is a rare but serious complication of pregnancy that typically occurs in the third trimester. It is usually considered a complication of preeclampsia, and is estimated to affect one to two pregnancies out of every 1000, and up to 10% of pregnant women with severe preeclampsia. 
The condition name, HELLP, is an acronym:
- H is for hemolysis, which is the breakdown of red blood cells. In HELLP syndrome, the red blood cells are broken down earlier than normal, which can lead to anemia;
- EL is for Elevated Liver enzymes, which indicates abnormal liver function, and;
- LP is for a Low Platelet count. Platelets are important in blood clotting, so a low platelet count is associated with an increased risk of excessive bleeding.
HELLP syndrome typically arises in the third trimester of pregnancy, but in some cases it may occur in the first week after the baby is born.
Women with HELLP syndrome may experience severe abdominal pain below their ribs, not unlike heartburn, except antacids will not relieve their pain. Other symptoms of HELLP syndrome can be easily confused with gall bladder disease or viral illnesses.
It is still not clear what causes some pregnant women to develop HELLP syndrome.
Risk factors for developing HELLP syndrome include:
Signs and symptoms
The symptoms of HELLP syndrome are often vague and can be easily confused with other medical conditions. Most cases of HELLP syndrome occur before the 37th week of pregnancy, but some cases may develop in the week after the baby is born.
Some of the signs and symptoms associated with HELLP syndrome can include:
Methods for diagnosis
Because HELLP syndrome is a serious complication, prompt medical diagnosis is important.
If your doctor suspects HELLP syndrome, they will perform a complete physical examination and order laboratory tests. Blood tests will measure liver enzymes, red blood cells and platelets. A urine test will measure protein levels.
The severity of HELLP syndrome is classified according to the blood platelet count as follows:
- Class I - severe thrombocytopenia, with platelets under 50,000 mm;
- Class II - moderate thrombocytopenia, with platelets between 50,000 and 100,000/mm, and;
- Class III - mild thrombocytopenia, with platelets between 100,000 and 150,000/mm.
Types of treatment
If the pregnancy is more than 34 weeks, definitive treatment for HELLP syndrome is delivery of the baby. Most symptoms and side effects associated with HELLP syndrome will go away two or three days after the baby is born.
If the pregnancy is less than 34 weeks, treatment may vary, depending on the severity of the condition, but some of the treatment options may include:
- Bed rest and hospital admission to enable closer monitoring of your condition;
- Corticosteroids to help the baby's lungs develop more rapidly;
- Antihypertensive medication to control high blood pressure;
- Blood transfusions for anemia and low platelet count;
- Magnesium sulfate to prevent seizures, and;
- Monitoring of the unborn baby.
Babies born to mothers with HELLP syndrome may be more affected by the condition than their mother.
Complications associated with HELLP syndrome may include:
- Placental abruption, where the placenta prematurely separates from the uterus;
- Placental failure, where the placenta is not able to supply the fetus with enough oxygen and nutrients;
- Extremely preterm birth;
- Kidney failure;
- Fluid in the lungs;
- Blood clots, stroke;
- Liver rupture, and;
- Death of the mother and/or the baby.
When treated early, women with HELLP syndrome can usually make a full recovery, with most of their symptoms and side effects resolving within a few days after delivery.
The outcome for the baby tends to be more variable. Babies with a smaller birth weight are at greater risk. They may need longer hospital stays and support with breathing.
There is no known way to prevent HELLP syndrome, but the likelihood of developing it can be reduced by:
- HELLP Syndrome: MedlinePlus Medical Encyclopedia. Accessed November 11, 2014. link here
- Austprem – HELLP. Accessed November 11 2014. link here
- HELLP Syndrome. American Pregnancy Association. Accessed November 11 2014. link here
- HELLP Syndrome and Preeclampsia-Topic Overview. Accessed November 11 2014. link here
- HELLP Syndrome...A Pregnancy Complication. MedicineNet. Accessed November 11 2014. link here
- HELLP Syndrome - Causes & Treatment Of HELLP Syndrome | Pregnancy Corner.Accessed November 11 2014. link here
- HELLP Syndrome: MedlinePlus Medical Encyclopedia. Accessed November 11 2014. link here
- HELLP Syndrome: Recognition and Perinatal Management - American Family Physician. Accessed November 11 2014. link here
- HELLP Syndrome: Risk Factors Symptoms & Diagnosis. Accessed November 11 2014. link here
- Preeclampsia.” Preeclampsia. Accessed November 11 2014. link here
- What Is the HELLP Syndrome? Accessed November 11 2014. link here
FAQ Frequently asked questions
What is HELLP syndrome?
HELLP syndrome is a rare and serious complication of pregnancy characterized by high blood pressure that, if left untreated, may lead to seizures and stroke.
What are the symptoms of HELLP syndrome?
The symptoms of HELLP syndrome can easily be confused with other conditions, but may include: headaches; nausea and vomiting that become increasingly worse; abdominal pain under the ribs, around the liver; blurry vision, and; fatigue.
Who gets HELLP syndrome?
HELLP syndrome typically occurs in the third trimester of pregnancy, or during the first week after delivery. It is more common in women over 25 years of age.
How is HELLP syndrome diagnosed?
HELLP syndrome is diagnosed by a thorough physical examination, and by tests including: blood and urine tests, and blood pressure measurements. Blood tests are used to determine the levels of red blood cells, liver enzymes and platelets. The urine sample …
How is HELLP syndrome treated?
Treatment for HELLP syndrome may vary, depending on the stage of pregnancy and severity of symptoms. If the pregnancy is more than 34 weeks, definitive treatment for HELLP syndrome is delivery of the baby. If the pregnancy is less than 34 weeks, treatment …
Can HELLP syndrome be prevented?
Although there is no known prevention for HELLP syndrome, the risk of developing HELLP syndrome may be decreased by maintaining good health and fitness before becoming pregnant, getting good prenatal care and telling your healthcare practitioner if you have …
Is HELLP syndrome serious?
HELLP syndrome is a rare but serious pregnancy complication. Early diagnosis and treatment are very important to improve outcomes for the mother and baby.
What increases the chances of developing HELLP syndrome?
Some of the known risk factors for HELLP syndrome include: having a history of HELLP syndrome; having diabetes; having preeclampsia; being over the age of 25, and; being Caucasian.