HELLP syndrome is a perilous pregnancy complication commonly considered to be a variant of preeclampsia. Both health issues usually happen at the later stages of pregnancy or, soon after childbirth.
Additionally, Hellp, even serious, is a rare condition for pregnant mothers. It has similar symptoms to preeclampsia like experiencing pain in the upper belly, blurry vision, fatigue, or swelling.
Mommies who have hellp syndrome before labor need to deliver their baby as soon as possible.
In this article, we will learn what it is, what are its symptoms, its risks factors, and its treatment. This will make soon-to-be mommies aware of this condition to resolve it, if may ever happen, quickly.
What is Hellp Syndrome?
Hellp syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. Dr. Louis Weinstein named it HELLP in 1982 after its composition:
- H as hemolysis or breaking down of red blood cells
- EL stands for elevated liver enzymes
- and LP for low platelet count.
This syndrome causes issues with your blood, liver, and blood pressure. Without treatment, these health problems may hurt you or your baby. There might be a link between HELLP syndrome and preeclampsia and eclampsia.
Early diagnosis is crucial because serious health problems and even death may occur in about 25% of cases. Therefore, awareness of hellp syndrome is helpful, to ensure the mother and baby's medical care.
Additionally, hellp syndrome often starts at 20 weeks of pregnancy. Hellp syndrome may cause major complications. These are the following:
- seizures
- stroke
- liver rupture
- placental abruption (separation of placenta from the uterus wall before giving birth)
Similar conditions
Similarities may mistake hellp syndrome for preeclampsia or eclampsia. Preeclampsia is a condition when a pregnant mother has high blood pressure and damage to organs such as the liver and kidneys. Eclampsia is a more fatal form of preeclampsia, which may include seizures.
Although, hellp can be difficult to diagnose, because all of the common signs of preeclampsia may not be detectable, like high blood pressure and protein in the urine. Its symptoms are usually similar and can be mistaken for gastritis, flu, hepatitis, acute fatty liver, gall bladder disease, and others.
Causes, symptoms and risk factors of hellp syndrome
The most common reason for mothers to become fatally ill or die from helllp syndrome are liver rupture or stroke (cerebral edema or cerebral hemorrhage). These crucial situations can be prevented when caught in time.
If you or someone you know has these symptoms and risk factors of hellp, you should seek for ASAP medical attention.
Causes
Doctors may not know what causes hellp. Your chance of it is higher if you have had it before. Most mothers who get it might have high blood pressure. However, even those mothers who have lower blood pressure may also be vulnerable to hellp.
Medical experts think you might have it at a high possibility if you are:
- Age, with risk increasing for mothers older than 25
- Caucasian
- History of hellp from previous pregnancy
- Previous labor and delivery, with risk increasing for mothers who gave birth
- have completed two or more times birth before
Symptoms
The external symptoms of hellp may seem at first like preeclampsia and might include one or more of the following symptoms below.
- Epigastric (abdominal) or substernal (chest) pain. These include abdominal or chest tenderness and upper right side pain.
- Nausea, vomiting, or indigestion with pain after eating
- Headache that can't be relieved, even after taking medication such as acetaminophen
- shoulder pain or pain when breathing deeply
- bleeding too much
- changes in vision including blurry vision, seeing double, or flashing lights or auras
- swelling, especially of the face of hands
- shortness of breath, difficulty in breathing, or gasping for air
- having a quick weight gain
In some rare cases, you might also experience uncontrolled nosebleeds and seizures or uncontrollable shaking of the body.
Hellp also includes the following signs to detect (which are measurable):
- High blood pressure
- protein in the urine
- abnormalities in laboratory blood work (increased liver enzymes, lower platelets, and indication of hemolysis)
Risks factors
The cause of hellp syndrome is yet to know, but there are some factors that might increase your risk of developing it.
Preeclampsia is the greatest risk factor. This health problem has a symptom of high blood pressure, and it usually happens during the last trimester of pregnancy. However, it might present in early pregnancy or postpartum (in rare cases).
Although, not all pregnant mothers who have preeclampsia will have a tendency to develop hellp.
Other risk factors for HELLP are the following:
- being over age 35
- a pregnant who is an African American
- being obese
- having previous pregnancies
- have diabetes or kidney disease
- always manifesting a high blood pressure
- with history of preeclampsia
You can be also prone to or have a higher risk for hellp if you had the condition in your previous pregnancy. Healthline.com's review of a study presented that the risk of prevalence for hypertensive disorders, including preeclampsia and Hellp, is about 18 percent.
Postpartum hemorrhage
Hemolysis, elevated liver enzymes, and low platelets syndrome can be a type of severe preeclampsia. Thus, it may also lead to severe medical complications.
One of these complications is postpartum hemorrhage (PPH) which may occur after delivery or birth. PPH is one of the fata clinical complications of hellp, which may indicate poor prognosis. Also, hellp syndrome is a serious threat to maternal and perinatal infant health conditions.
In addition, hellp can result in bleeding and blood clotting problems. In some cases mothers with hellp, they tend to develop disseminated intravascular coagulation (DIC). It is a type of blood clotting condition that might lead to heavy bleeding or hemorrhage.
How is HELLP diagnosed?
Your doctor or health care unit will perform a physical screening and order different tests if there is an indication of hellp. During the exam, your doctor may feel for abdominal tenderness, an enlarged liver, and excessive swelling.
These can be a sign of a liver problem. Your doctor may check your blood pressure, too.
Some tests can also help your doctor or health care provider make a diagnosis. They will also order the following:
- blood tests to assess platelet levels, liver enzymes, and red blood cell count
- urine test to examine abnormalities of protein composition
- magnetic resonance imaging (MRI) to check if there is bleeding in your liver
Treatment for hellp
Once HELLP syndrome is diagnosed with confirmation, delivery of your baby is the best way to prevent further complications. This should refrain from the progression of the disease. In other cases, the baby is prematurely born.
But, your treatment may vary depending on the fatality of your symptoms and how close are you to your due date. If your hellp symptoms are mild or if your baby is less than 34 weeks old, your doctor may suggest the following:
- blood transfusions to treat anemia and low platelet levels
- magnesium sulfate to avoid seizures
- antihypertensive medication to alleviate blood pressure
- corticosteroid medicine to help your baby's lungs mature in case an emergency delivery is needed
During your treatment, your doctor may monitor your red blood cell, platelets, and liver enzyme levels. Your baby's health will be watched closely, too.
Your doctor might suggest certain prenatal tests that assess movement, heart rate, stress, and blood flow. Expect that you will be hospitalized for close monitoring.
Always a reminder that mommies should be knowledgeable, in order to accumulate quick resolution to any possible obstetric complications.
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