HELLP syndrome is a group of symptoms that occur in pregnant women who have:
- H —
hemolysis(the breakdown of red blood cells)
EL — elevated liver enzymes
LP — low
Causes, incidence, and risk factors
The cause of HELLP syndrome has not been found.
HELLP syndrome occurs in about 1 to 2 out of 1,000 pregnancies, and in 10-20% of pregnant women with severe
Most often HELLP develops before the pregnancy is 37 weeks along. Sometimes it develops in the week after the baby is born.
Many women have high blood pressure and are diagnosed with preeclampsia before they develop HELLP syndrome. In some cases, HELLP symptoms are the first warning of preeclampsia and the condition can be misdiagnosed as:
Flu or other viral illness
Idiopathic thrombocytopenic purpura(ITP)
- Lupus flare
Thrombotic thrombocytopenic purpura
- Fatigue or feeling unwell
- Fluid retention and excess weight gain
- Nausea and vomiting that continues to get worse
- Pain in the upper right part of the abdomen
- Blurry vision
- Nosebleed or other bleeding that won’t stop easily (rare)
Seizuresor convulsions (rare)
Signs and tests
During a physical examination, the doctor may discover:
Abdominal tenderness, especially in the right upper side
High blood pressure
Swelling in the legs
Tests of the baby’s health will be done. Tests include
The main treatment is to deliver the baby as soon as possible, even if the baby is premature. Problems with the liver and other complications of HELLP syndrome can quickly get worse and be harmful to both the mother and child.
Your doctor may induce labor by giving you drugs to start labor, or may perform a
You may also receive:
A blood transfusion if bleeding problems become severe
Corticosteroid medications to help the baby’s lungs develop faster
Medications to treat high blood pressure
When the condition is not treated early, up to 1 of 4 women develop serious complications. Without treatment, a small number of women die.
The death rate among babies born to mothers with HELLP syndrome depends on birth weight and the development of the baby’s organs, especially the lungs. Many babies are born
HELLP syndrome may return in up to 1 out of 4 future pregnancies.
There can be complications before and after the baby is delivered, including:
Disseminated intravascular coagulation(DIC) — a clotting disorder that leads to excess bleeding (hemorrhage)
Fluid in the lungs (
Liver hemorrhage and failure
Separation of the placenta from the uterine wall (
After the baby is born and HELLP syndrome has time to improve, most of these complications will go away.
Calling your health care provider
If symptoms of HELLP syndrome occur during pregnancy:
See your obstetrician right away
Call the local emergency number (such as 911)
Get to the hospital emergency room or labor and delivery unit
There is no known way to prevent HELLP syndrome. This is why it is important for all pregnant women to start prenatal care early and continue it through the pregnancy. This allows the health care provider to find and treat conditions such as HELLP syndrome early.