HELLP Syndrome in Pregnancy

woman in labor at hospital
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Wonder what is HELLP Syndrome? HELLP Syndrome is a problem that is associated with preeclampsia or eclampsia in pregnancy.  It was first named in 1982 for it's symptoms by Dr. Louis Weinstein. About 5-8% of pregnant women get preeclampsia. Typically, you will see it with the more severe cases of preeclampsia. About 15% of women with preeclampsia/eclampsia will have HELLP Syndrome, which is a combination of the following symptoms:

  • H - hemolysis
  • EL - elevated liver enzymes
  • LP - low platelet count

When you start having issues with preeclampsia, your doctor or midwife may order additional testing to rule out HELLP. You might have blood work and a 24 hour urine collection. The blood work is to check on the liver enzymes and your platelet count. A physical exam may reveal that your upper abdomen is tender when touched, indicating that your liver may be enlarged.

Signs of HELLP Syndrome

  • Nausea (with or without vomiting)
  • Upper abdominal pain
  • High liver enzymes
  • Low blood platelets
  • Shoulder pain

Sometimes HELLP is misdiagnosed as something else, including a gall bladder attack. Be sure to talk to your practitioner about the testing and treatment if you're not feeling better.

How is HELLP Treated?

HELLP syndrome needs to be treated early for the best results for you and the baby. The treatment for HELLP is to give birth. This means that your baby will need to be born either by induction of labor or a cesarean, depending on where you are in your pregnancy and how severe your symptoms are of HELLP.

This is done even if your baby is premature, as HELLP gets bad rather quickly and is reversed only with birth. If it's not treated early, about 25 of the mothers have very serious, lasting effects, including liver damage. The complications for babies depend on the point in gestation that they were born and the seriousness and length of complications experienced by the mother.

About 25% of mothers will die worldwide from HELLP syndrome. Many will have other complications from this devastating disease. Your baby's risks depend largely on how pregnant you were when birth occurred and if you were able to have steroids before birth. If your baby weighs more than two pounds there is the same rate of survival and risk of complications of similarly born babies, which is significant, but better than the outcomes of those less than two pounds. The mortality rate for babies is about 7.7-60%, including stillbirths and babies who die in the first month of life.

Will I get HELLP again?

The risk of having HELLP in another pregnancy is from 2-19%. This is enough to deter many women from attempting another pregnancy. One of the biggest predictors of whether or not you will have it again, is the point in pregnancy in which it first appeared. The earlier the onset, the more likely it is to happen again. A good conversation with your doctor and high risk obstetrician will be beneficial in planning a future pregnancy.


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