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HELLP Syndrome

What is HELLP syndrome?

HELLP syndrome is a rare but life-threatening condition in pregnancy. It causes red cells in the blood to break down. It also causes problems with the liver, bleeding, and blood pressure. It is often linked with preeclampsia and eclampsia. It often develops before delivery. But it may also occur after delivery. The letters in the word HELLP stand for:

  • Hemolysis. This is the breakdown of red blood cells.
  • Elevated Liver enzymes. Damage to liver cells causes changes in the way the liver works.
  • Low Platelets. Platelets are cells in the blood that help the blood to clot to control bleeding.

What causes HELLP syndrome?

Doctors do not know what causes HELLP syndrome.

Who is at risk for HELLP syndrome?

You are more likely to get HELLP syndrome if you:

  • Have preeclampsia or eclampsia during pregnancy
  • Had another pregnancy with HELLP syndrome
  • Have a sister or mother who had HELLP syndrome

What are the symptoms of HELLP syndrome?

These are the most common symptoms of HELLP syndrome:

  • Pain in the top right side of your belly (abdomen) or around your stomach
  • Nausea or vomiting
  • Headache
  • Blurry vision
  • High blood pressure
  • Protein in the urine
  • Swelling (edema)

The symptoms of HELLP syndrome may look like other health conditions. These include other high blood pressure problems in pregnancy. Always see your doctor for a diagnosis.

How is HELLP syndrome diagnosed?

Your doctor will review your health history and do a physical exam. Other tests include:

  • Blood pressure measurement
  • Red blood cell count
  • Blood tests for enzymes that show cell damage
  • Measurement of bilirubin level. This is a substance made by the breakdown of red blood cells.
  • Liver function tests
  • Platelet count
  • Urine tests for protein

How is HELLP syndrome treated?

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
  • Hospital stay with fetal monitoring. This 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 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 liver, urine, and blood. These may tell if HELLP syndrome is getting worse.
  • Corticosteroid medicines to help the baby's lungs mature for delivery

You may deliver your baby early if HELLP syndrome gets worse and puts the health of you or your baby in danger.

What are the complications of HELLP syndrome?

Complications may include:

  • Poor blood flow to your organs
  • Seizures
  • Anemia
  • Blood clotting problems
  • Placenta problems
  • Liver problems
  • Fluid buildup in your lungs
  • Early delivery

If HELLP syndrome is severe, you and your baby may be in danger. You may need to deliver the baby early to prevent more problems. It may take several days after delivery to recover from HELLP syndrome.

How can HELLP syndrome be prevented?

Watching for signs of HELLP syndrome may help prevent some complications. Learning about the warning signs can help you get early treatment and prevent the disease from getting worse.

Key points about HELLP syndrome

  • HELLP syndrome is a life-threatening problem in pregnancy. It can cause problems with the liver, bleeding, and blood pressure.
  • Doctors do not know what causes HELLP syndrome.
  • You may need to deliver your baby early.
  • Finding out if you are at risk for HELLP syndrome may help prevent some complications of the disease.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Medical Reviewers:

  • Berry, Judith, PhD, APRN
  • Bowers, Nancy, RN, BSN, MPH