What is HELLP Syndrome?

HELLP syndrome is a rare but serious condition that can happen when you’re pregnant  or right after you have your baby. There are still many questions about the serious condition of HELLP syndrome. The cause is still unclear to many doctors and often HELLP syndrome is misdiagnosed. It is named for 3 features of the condition:

Hemolysis: This is the breakdown of red blood cells. These cells carry oxygen from your lungs to your body.

Elevated Liver Enzymes: When levels are high, it could mean there’s a problem with your liver.

Low Platelet Count: Platelets help your blood clot.

It is often assumed that HELLP Syndrome will always occur in connection with preeclampsia, but there are times when the symptoms of HELLP will occur without a diagnosis of preeclampsia being made. About 4-12% of women with diagnosed preeclampsia will develop HELLP syndrome. Unfortunately since the symptoms of HELLP syndrome may be the first sign of preeclampsia, this is what can often lead to a misdiagnosed. The symptoms of HELLP may cause misdiagnosed of other conditions such as hepatitis, gallbladder disease, or idiopathic/thrombotic thrombocytopenic purpura (ITP), which is a bleeding disorder.

Cause

The cause of HELLP syndrome is unclear. Although it is more common in women who have preeclampsia or pregnancy induced hypertension (high blood pressure during pregnancy), some women develop HELLP syndrome without showing signs of these conditions.                        

The following risk factors may increase a woman’s chance to develop HELLP syndrome:

• Having a previous pregnancy with HELLP syndrome
• Having preeclampsia or pregnancy induced hypertension
• Being over age 25
• Being Caucasian
• Multiparous (given birth 2 or more times)

In less than 2 percent of women with HELLP syndrome, the underlying cause appears to be related to LCHAD deficiency in the fetus.

A variety of genetic factors (both in the mother and fetus) have been found to play a role in the development of preeclampsia and HELLP syndrome. However, the condition is likely multifactorial. This means that several genetic and environmental factors likely interact to cause HELLP syndrome, and no one gene is thought to be responsible for the condition.   

Some women may have a genetic predisposition to developing preeclampsia and related conditions, such as HELLP syndrome. This means that certain genetic factors increase a woman’s risk to develop HELLP syndrome. However, many women with a genetic predisposition will never develop HELLP syndrome.

Symptoms

The most common symptoms of HELLP syndrome include:

• Headaches
• Nausea and vomiting that continue to get worse–(This may also feel like a serious case of the flu).
• Upper right abdominal pain or tenderness
• Fatigue or malaise
• Nosebleed
• Seizures

A woman with HELLP may experience other symptoms that often can be attributed to other things such as normal pregnancy concerns or other pregnancy conditions.

• Visual disturbances
• High blood pressure          
• Protein in urine
• Edema (swelling)
• Severe headaches
• Bleeding that doesn’t stop as quickly as usual    

Diagnosis

If you have symptoms of HELLP syndrome, talk to your doctor. She’ll do a physical exam and tests to check for things like:

• High Blood pressure                 
• Pain in the upper right side of your belly
• Enlarged Liver                             
• Swollen legs
• Liver Function                          
• Blood platelet count
• Bleeding into your liver

Treatments

The main solution for HELLP syndrome is to give birth as soon as possible. This means your baby may have to be born early. The risks are too serious for you and your baby if you stay pregnant with HELLP syndrome.

Treatment may also include:

• Corticosteroid medicine to help your baby’s lungs develop more quickly
• Medicine for high blood pressure
• Meds to prevent seizures
• Blood transfusion        

Prevention

There’s no way to prevent HELLP syndrome. Since HELLP syndrome is believed to be related to preeclampsia, staying vigilant about diet, exercise and a healthy blood pressure can only help. The best thing you can do is keep yourself healthy before and during pregnancy and watch for early signs of the condition. The following steps can help:

• See your doctor regularly for prenatal visits.
• Tell your doctor if you’ve had any high-risk pregnancies or someone in your family has had HELLP syndrome, preeclampsia, or other blood pressure problems.
• Know the symptoms and call your doctor ASAP if you have them.   

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Resources:

https://rarediseases.info.nih.gov/diseases/8528/hellp-syndrome

https://www.webmd.com/women/what-is-hellp-syndrome#1