HELLP Syndrome is a rare, life-threatening pregnancy disorder that can recur in subsequent pregnancies. Babies in the womb are exposed to developmental and other serious conditions, often linked with preeclampsia and eclampsia. Blurred vision, abdominal pain, and fatigue are some of the symptoms. Treatment includes medication or, ultimately, early delivery.
What is HELLP syndrome?
HELLP syndrome is a rare pregnancy disorder that affects the liver and blood.
HELLP is an acronym for three abnormalities derived from the initial lab analysis and included:
- Hemolysis: Refers to a breakdown of red blood cells, which occurs rapidly. This mainly results in low red blood cell levels, which can lead to anemia, a condition characterized by the inability of the blood to carry enough oxygen to the rest of your body.
- Elevated Liver enzymes: Speeds up your body’s reaction in breaking down proteins. Inflamed or injured liver cells leak high amounts of chemicals, including enzymes, into your blood.
- Low Platelets: Platelets are components of your blood that regulate blood clotting. Low platelet levels increase the risk of excessive bleeding.
HELLP syndrome affects less than 1% of all pregnancies but remains a major health concern and can be life-threatening to you and your unborn baby.
HELLP syndrome usually occurs after the 20th week of pregnancy but may occur earlier or even after childbirth.
Symptoms of HELLP syndrome
The symptoms of HELLP syndrome are wide-ranging and vague, which can often be difficult to diagnose initially.
Symptoms tend to be very similar to those of the stomach flu and may be mistaken for normal pregnancy symptoms.
Signs of HELLP syndrome include:
- Abdominal pain, usually in the right upper abdomen
- Blurred vision
- Malaise or fatigue
- Edema (swelling) and quick weight gain
- Nausea and vomiting
- Headaches
- Uncontrolled nosebleeds
- Seizures or uncontrollable body shakes
Who is at risk of HELLP syndrome?
The cause of HELLP syndrome is unknown, but some experts believe HELLP is a severe form of preeclampsia, a condition related to high blood pressure.
Between 10% and 20% of women who develop preeclampsia will also develop HELLP syndrome.
Pre-existing conditions such as:
- High blood pressure
- Diabetes
- Advanced maternal age
- Carrying multiples, such as twins
- Having a previous history of preeclampsia
Although HELLP is associated with preeclampsia, these are two different conditions.
Preeclampsia leads to high blood pressure, which brings on hypertension and proteinuria, characterized by high protein levels in the urine.
HELLP syndrome patients may not have high blood pressure or proteinuria, but the condition can lead to serious blood and liver disorders.
How does HELLP syndrome affect my baby?
HELLP syndrome does not affect your newborn baby’s liver function or other organs with early treatment, but premature birth may lead to other health complications or an increased mortality rate.
Infants of mothers with HELLP syndrome can face various complications, each with their own risks.
Prematurely born infants face multiple complications, including respiratory distress syndrome and chronic lung disease.
While in your womb, your baby could be deprived of nutrients required for adequate growth caused by reduced blood flow to the placenta.
However, if your baby weighs at least two pounds (about 900 grams) at birth, the related health risks and survival rate is consistent with non-HELLP babies of the same size.
Although premature birth is part of the necessary treatment to preserve your and your baby’s health, doctors will try to maintain your pregnancy for as long as possible without placing you or your baby at risk.
The longer you can maintain a safe pregnancy, the better the outcomes for your little one will be.
Complications of HELLP syndrome
If untreated, HELLP syndrome can lead to serious complications, including:
- Blood clots
- Heavy bleeding
- Kidney failure
- Placental abruption (where the placenta separates from the uterus before birth)
- Pulmonary edema
- Early delivery
- Poor blood flow to organs
- Seizures
- Anemia
- Liver problems
HELLP syndrome is rarely life-threatening if treated early. Most women show signs of improvement within two days of giving birth.
HELLP syndrome diagnosis
Diagnosing HELLP syndrome begins with a medical questionnaire and examination.
Your doctor will ask you about any physical changes you are experiencing, such as abdominal pain, especially in the upper right side of your abdomen, and swelling of your legs.
During the examination, your doctor may feel for abdominal tenderness, an enlarged liver, and any excess swelling, which are signs of a liver problem.
Your doctor will also check your:
- Blood pressure
- Blood tests will be conducted to check your blood count
- Liver and kidney function
- A urine test will be done to check for abnormal proteins
- Platelet count
In severe cases, your doctor may use an ultrasound or CT scan to check for an enlarged liver or bleeding in your liver.
HELLP syndrome treatment
Treatment for HELLP syndrome is delivery which in most cases might be an early delivery, either with medicine to induce labor or having a cesarean birth (C-section).
A C-section can cause complications if you have blood-clotting issues related to low platelet levels. Treatment may include:
- Bed rest, either at home or in the hospital
- Blood transfusions for severe anemia and low platelet count
- Medicine to prevent seizures
- Medicine to lower blood pressure
A Hospital stay with fetal monitoring includes:
- Non-stress testing. This test measures the fetal heart rate when the baby moves.
- Biophysical profile. This test combines the non-stress test with an ultrasound to see the developing baby.
- Doppler flow studies. This is a type of ultrasound that uses sound waves to measure the flow of blood through a blood vessel.
- Lab tests of the liver, urine, and blood may indicate if HELLP syndrome worsens.
- Corticosteroid medicines help the baby’s lungs mature for delivery.
- Blood transfusion if your condition is severe.
Early delivery will be necessary if HELLP syndrome worsens and puts your or your baby’s health in danger.
FAQs
What are the long-term effects of HELLP Syndrome on the baby?
Studies suggest that offspring exposed to preeclampsia are at a higher risk of developing cardiovascular, metabolic, and neurological diseases and other diseases.
The long-term effects of HELLP syndrome are subject to how far in your pregnancy you were at childbirth and if normal development was impeded in any way.
Premature birth may present long-term health issues.
Can lifestyle changes help reduce the risk of HELLP Syndrome?
There is no known way to prevent HELLP syndrome, but you can increase your chances of having a healthy pregnancy by eating a nutrient-dense diet of whole grains, lean protein, fruits, and vegetables.
Low-intensity exercise and adequate quality sleep are also helpful. Finally, you should schedule regular prenatal care visits.
How likely is it that HELLP Syndrome will recur in subsequent pregnancies?
If you have had HELLP syndrome once, your risk of recurrence will be higher. About half of all women with HELLP syndrome can have some hypertensive disorder in their next pregnancy.
Takeaway
Research and data analysis on HELLP syndrome is ongoing, as with many medical conditions.
You can lessen your chances of developing HELLP syndrome by adopting a healthy lifestyle with a well-balanced diet and regular exercise.
You should avoid excessive alcohol intake, smoking, and other harmful substances. Monitoring and maintaining your weight relative to your height should be part of your lifestyle regimen.
This will lessen the risk of developing HELLP during your pregnancy.
References
- https://my.clevelandclinic.org/health/diseases/21637-hellp-syndrome#:~:text=There%20is%20no%20known%20way,catch%20problems%20like%20HELLP%20early.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736667/#:~:text=Studies%20suggest%20that%20offspring%20exposed,as%20well%20as%20other%20diseases.
- https://www.stanfordchildrens.org/en/topic/default?id=hellp-syndrome-90-P02454
- http://academyofneonatalnursing.org/NNT/Antepartum_HELLP.pdf
- https://www.healthline.com/health/hellp-syndrome#prevention
- https://my.clevelandclinic.org/health/diseases/21637-hellp-syndrome
