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Definition

HELLP syndrome is a rare but serious condition (a form of preeclampsia]]> ) that occurs during pregnancy or just after delivery. HELLP stands for:

  • H emolysis
  • E levated
  • L iver enzymes (showing liver damage)
  • L ow P latelet count

HELLP involves three types of problems:

  • Hemolysis—(the destruction of red blood cells) can lead to ]]>anemia]]> (low red blood cells) and feeling tired.
  • High liver enzymes—liver enzymes are chemicals in the blood that show how well the liver is working. High levels of enzymes mean the liver has been damaged.
  • Low platelet count—since platelets are cells that help bleeding stop, a low level of platelets can lead to problems with bleeding too long.

Red Blood Cells

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The Liver

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Causes

The causes of HELLP syndrome are unknown. The syndrome occurs in about 4 of every 1,000 pregnancies.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Most women who get HELLP have blood pressure problems before HELLP develops.

Risk factors for HELLP syndrome:

  • Age: over 25
  • Race: White
  • Two or more previous deliveries
  • Serious problem with a previous pregnancy
  • Preeclampsia or HELLP in a previous pregnancy

Symptoms

Some women may have no symptoms at all.

Symptoms of HELLP syndrome:

  • Feeling tired
  • Pain in your upper right abdomen
  • Bad headaches
  • Nausea
  • Vomiting
  • Black spots in your vision

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. You may need to be referred to a doctor who specializes in obstetrics.

Tests may include:

  • Complete blood count—a blood test that checks the number of red blood cells and platelets, two types of blood cells that are low in HELLP syndrome
  • Liver function tests—a blood test that looks at how well your liver is working

Treatment

Your doctor may send you to a hospital that can provide special care for pregnant women.

Treatment options include the following:

Delivery

The only cure for HELLP syndrome is delivery of your baby. If your case is not severe and you are 34 weeks pregnant or less, your doctor may recommend trying other treatments until you reach 34 weeks of pregnancy. These treatments include strict bed rest, a low-salt diet, and drinking a lot of fluids.

Medications

  • Corticosteroids (to assist the fetal lungs to mature)
  • Magnesium sulfate to prevent seizures
  • Blood pressure medications, if your blood pressure is high

In some cases of HELLP, transfusions of platelets or red blood cells are used to increase the number of these cells in the blood.

Prevention

There is no known way to prevent HELLP syndrome. If you have HELLP with one pregnancy, you are at increased risk to develop it again during another pregnancy. See your doctor regularly during pregnancy so that if you develop the condition, it can be treated.