HELLP Syndrome
Published on March 5th, 2021. Information will be updated
HELLP syndrome is a complication of preeclampsia that can be life-threatening. This complication occurs in the late stages of pregnancy or after childbirth. HELLP was discovered in 1982 by Louis Weinstein and named after its abbreviated characteristics. HELLP stands for hemolysis (H), elevated liver enzymes (EL), and low platelet count (LP). This complication is challenging to diagnose as it mimics other diseases such as gastritis, flu, acute hepatitis, gall bladder disease, and other conditions. Sadly, the mortality rate is relatively high as 30% of mothers or becoming to be mothers who have HELLP syndrome pass away. Physicians would discuss this with potential mothers to prevent any action from getting HELLP syndrome.
Causes
Note: Research about it
Risk Factors
Patients who are female and pregnant are likely to develop preeclampsia to result in HELLP syndrome. Around 8% of pregnant women develop preeclampsia, and out of those affected, 15% of those patients will likely develop HELLP syndrome. Although it is a rare complication, it is best to prevent this syndrome from developing. Additionally, around 48,000 women are affected with HELLP syndrome. The cases of HELLP syndrome will lower if the patient gets diagnosed and treated early. Women who had HELLP syndrome while pregnant could potentially get it again (known as relapse) if they decide to become pregnant once more. Preeclampsia is 16-52% likely to occur in the next pregnancy, increasing the risk of developing HELLP syndrome, especially when the pregnant woman is in her second trimester. The recurrency of HELLP syndrome is 2 to 19%, depending on where the patient lives.
Signs and Symptoms
The symptoms are similar to preeclampsia, but the patients would have more than one of these symptoms. Symptoms such as headaches, nausea, vomiting, indigestion, pain after eating, abdominal or chest tenderness, shoulder pain, or pain when breathing deeply, bleeding, vision changes and swelling occur in both preeclampsia HELLP syndrome. Physicians should look out for signs such as high blood pressure and protein in the urine. The main reason pregnant women affected with HELLP syndrome is likely to die liver rupture or strokes such as cerebral edema or cerebral hemorrhage. If physicians diagnose this condition early, the patient won’t die as she will be treated immediately. Therefore, go to the hospital if you feel something is wrong.
Diagnosis
Diagnosis not mentioned. Research on that. There are classifications for HELLP syndrome. HELLP syndrome classification is identified by measuring the blood platelet count and putting it to either Class I, II, or III. Class I occurs when there are significantly fewer thrombocytes (known as severe thrombocytopenia), the platelet count is under 50,000/mm3. Class II is when there are few thrombocytes, but not like that of class I (therefore, moderate thrombocytopenia). Lastly, class III is when the platelet count is below normal (therefore, mild thrombocytopenia), which is around 100,000 to 150,000/mm3.
Treatment
The best treatment for people with HELLP is to deliver the baby and not aborting it. If the patient aborts the baby, symptoms will become worse, and she will die. While pregnant, the physician or OB/GYN provides blood products for transfusion. Medications such as corticosteroids may help the baby’s lungs develop during early pregnancy. However, healthcare providers may prescribe steroids for the pregnant patient to take.
Prevention
To prevent symptoms of HELLP syndrome from developing is to get exercise before getting pregnant, have regular prenatal visits during pregnancy, tell the physician the symptoms you are having, inform healthcare providers about any family member who had HELLP syndrome, and lastly, trust yourself and think that something is not right when the symptoms occur. These preventions will significantly decrease the mortality rate in patients with HELLP syndrome if every pregnant woman does this.
Effect on the Baby
Although this syndrome affects pregnant women in their second trimester, babies will become involved as well. If the baby weighs two pounds after delivery, they will have the same survival rate as babies born by a non-HELLP syndrome-affected mom, which is significantly low. Babies that weigh two pounds require hospital care as they are not fully developed. Unfortunately, physicians can’t determine whether or not they will become less developed while the mom is giving labor. However, if the pregnant woman is diagnosed early, the physician will request the patient to see how the baby is regularly growing.
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In developed countries, the mortality rate for babies who are in the womb for more than 20 weeks is 51 out of 1,000 pregnancies. Unfortunately, the rate is higher when pregnant women have preeclampsia or eclampsia which ranges from 7.7 to 60% stillbirth rate. The cause of the miscarriage was when the placenta ruptured which separated the placenta and the uterus.
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Resources
W. (17 January 2020). Hellp Syndrome. Preeclampsia Foundation - Helping Save Mothers and Babies from Illness and Death Due to Preeclampsia. https://www.preeclampsia.org/hellp-syndrome