HELLP Syndrome in Pregnancy

Pregnancy can be one of the most exciting, joyful, and memorable times of your life. After all, you are now looking forward to welcoming a new member to your family. However, pregnancy can also be a very scary time, filled with all sorts of discomforts and worries. Many women worry about developing HELLP syndrome during their pregnancies. HELLP syndrome is a condition related to preeclampsia, which can potentially threaten the health of both mother and baby.

What is HELLP Syndrome?
HELLP syndrome is a severe form of preeclampsia, characterized by high blood pressure, vomiting, and other symptoms. The term HELLP is an anagram, made up of the first letters of the three main signs of the illness: Hemolysis (the breakdown of red blood cells in the body), Elevated Liver function, and Low Platelet count (which contributes to poor blood clotting). HELLP syndrome typically develops in the third trimester of pregnancy, though it can occur earlier. Some women also develop HELLP syndrome in the days immediately following delivery.

HELLP syndrome occurs very rarely, only affecting between 0.2% and 0.6% of all pregnant women in North America. Pregnant women with preeclampsia are more likely to develop HELLP syndrome. In fact, about 10% of women with preeclampsia will develop the condition. The majority of HELLP sufferers do recover fully. Unfortunately though, 2% of women and 8% of babies affected by HELLP syndrome die as a result of complications caused by the illness.

What Causes HELLP Syndrome?
No one is really sure what causes HELLP syndrome. It seems to be related to preeclampsia and eclampsia, and usually occurs as a complication of one of these conditions. However, HELLP syndrome can also occur in the absence of both preeclampsia and eclampsia.

Who’s At Risk For HELLP Syndrome?
Unfortunately, because no cause for HELLP syndrome is yet known, doctors aren’t able to pinpoint who will develop the condition. It seems that any pregnant woman is at risk for developing HELLP syndrome, though there are a few factors that may increase your risk. These include:

• being under 20 or over 35
• being pregnant for the first time
• having high blood pressure, preeclampsia, or eclampsia during your pregnancy
• having HELLP syndrome, preeclampsia, or eclampsia during a previous pregnancy

Symptoms of HELLP Syndrome
HELLP syndrome is often accompanied by a number of different symptoms. It is important that you be aware of these symptoms and seek medical help immediately if you develop any of them. Symptoms include:

• nausea
• vomiting
• severe headaches
• pain in the upper right side of the abdomen, just under the ribs
• edema, or water retention
• high blood pressure
• convulsions
• low blood platelet count
• elevated liver enzyme count

Sometimes the pain caused by HELLP syndrome can be confused with heartburn. If your heartburn does not radiate up your chest or does not subside after taking antacids, visit with your health care provider for an examination.

Treating HELLP Syndrome
There is no easy cure for HELLP syndrome. The only sure way to control the syndrome is by delivering the baby. If your baby is older than 34 weeks, it is likely that she will be delivered immediately, probably by cesarean section. Typically, symptoms disappear within a week of delivery.

If your baby is under 34 weeks and your symptoms are less severe, your health care provider may recommend bed rest and close monitoring until your baby reaches 34 weeks. You may be given medications to control your high blood pressure, along with increased fluids. You may receive intravenous corticosteroids, which will help your baby’s lungs to grow and develop more quickly.

Complications Associated With HELLP Syndrome
There are a number of complications of HELLP syndrome. Mothers are especially at risk if they develop HELLP syndrome. Possible complications include:

• seizures, as a result of restricted blood flow to the organs caused by high blood pressure
• anemia, caused by breakdown of red blood cells
• problems with blood clotting, including Disseminated Intravascular Coagulation (DIC), which can cause internal hemorrhaging.
• placental abruption
• difficulty breathing, caused by fluid buildup in the lungs
• liver damage or liver failure
• kidney damage or kidney failure
• stroke

Possible Effects on Baby
If your baby is over 37 weeks of age, it is very likely that she will suffer no physical complications as a result of HELLP syndrome. Younger babies may face long term effects of Hellp syndrome, such as growth retardation or complications associated with premature birth.

Preventing HELLP Syndrome
There is no surefire way to prevent HELLP symdrome. However, by having frequent medical checkups and by taking care of your body, you are more likely to avoid developing the condition.

If you are at high risk for developing HELLP syndrome, be sure to be monitored by your health care provider. If you notice any symptoms of HELLP syndrome, call your health care practitioner or go to the nearest emergency room.

Concerned about HELLP? Visit our Pregnancy Complications forum to learn more about it from other pregnant women