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HELLP Syndrome: What Do You Need to Know about This Complication?

HELLP syndrome is pregnancy complication that while rare—affecting about 0.4 percent of pregnancies—can also be serious. This condition actually refers to a series of symptoms, and like preeclampsia signs, it can be tricky to distinguish signs of concerns from pregnancy symptoms.

Unfortunately, HELLP syndrome cannot be prevented, but with early diagnosis, you can seek medical attention as soon as possible, and early intervention is key to management. To help you better understand this condition and what to look for, this post will explain:

  • What is HELLP syndrome?
  • What are the signs of this condition?
  • How is it treated?
  • Who is at risk for HELLP syndrome?
  • How is this complication different from preeclampsia?

What is HELLP syndrome?

HELLP syndrome stands for:

  • HE: Hemolysis, or the breaking down of red blood cells (which are important for carrying oxygen throughout the body)
  • EL: Elevated liver enzymes, or liver dysfunction
  • LP: Low levels of platelets (which are important for helping blood clot)

This condition can be serious because it can result in multiple organ failure for the mother, hemorrhage, placenta abruption, and fetal distress and growth complications.

What are signs of HELLP syndrome?

Symptoms usually arise before 37 weeks of pregnancy, but it’s important to know that symptoms can develop after giving birth and even earlier in pregnancy.

Here are the following signs of HELLP syndrome:

woman in bed
  • Belly pain, particularly in the upper right side
  • High blood pressure
  • Swelling
  • Blurred vision
  • Fatigue
  • Rapid weight gain
  • Headache
  • Nausea and/or vomiting
  • Nosebleed

You might notice that some of these symptoms, like nausea and swelling, are fairly normal during pregnancy, so it can be difficult to tell the difference between the expected morning sickness and pregnancy weight gain and actual red flag symptoms. It’s important to track when these symptoms occur and report any changes to your doctor, especially if you’re at risk for this condition, which we explain more in the next section.

What are risk factors for HELLP syndrome?

Here are the following factors that are known to increase risk for HELLP syndrome.

  • Previous pregnancy with HELLP syndrome increases risk of developing it again
  • Previous pregnancy with preeclampsia
  • Previous pregnancy with hypertension
  • Being over the age of 25
  • Having given birth two or more times
  • Being of Caucasian background

How is this syndrome diagnosed?

If you’re experiencing symptoms related to this condition, your doctor can run blood tests to measure liver function, platelet counts, and red blood cell counts to diagnose HELLP syndrome. Also, your blood pressure and urine protein levels may also be monitored.

How is HELLP syndrome treated?

Similar to preeclampsia, treatment of HELLP symptoms usually means delivering the baby. However, this treatment option depends on how many weeks pregnant you are.  If you are at least 37 weeks along, then your doctor will likely recommend delivery to prevent serious complications for you and your baby, and symptoms usually go away within two to three days after delivery.

However, delivering before that point in pregnancy is considered preterm birth, which also carries risk for your baby. In this case, your doctor will have to assess the risks of preterm birth in comparison to the risks of HELLP syndrome complications. To manage symptoms and extend gestation, your doctor may recommend:

  • Hospital admission and bed rest to ensure close monitoring
  • Corticosteroid treatment to accelerate the baby’s lung development
  • Magnesium sulfate to reduce the risk of seizures
  • Blood transfusion to increase platelet counts
  • Blood pressure mediation to ensure normalizing of this measure
  • Fetal monitoring to detect any distress the baby could be in

How is it different from preeclampsia?

HELLP syndrome is currently considered a severe form of preeclampsia, and it often precedes preeclampsia diagnosis. While it’s still being debated whether HELLP syndrome is a completely separate illness from preeclampsia, it’s important to know that it is definitely possible for women to experience both conditions at the same time. According to the American College of Obstetrics and Gynecology, approximately 4 – 12 percent of women with preeclampsia also have HELLP syndrome [1.]. One study found that for women with HELLP syndrome symptoms before 34 weeks of pregnancy, they were more likely to also develop preeclampsia in comparison to women whose symptoms developed after 34 weeks of pregnancy, so timing of symptom onset seems to be important for better detecting when this overlap happens.

Aarthi Gobinath, PhD

Aarthi Gobinath earned her PhD in neuroscience from the University of British Columbia. Her research covers the ways that stress affects the male and female brain differently.

She tackled the issue of sex bias in research by looking at why standard treatments for depression don't always work in the case of postpartum depression. Her work has been covered by Vice and Massive Science.

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