What Is HELLP Syndrome?

A treatable pregnancy complication

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While you might be familiar with preeclampsia, a disorder that occurs during pregnancy that involves high blood pressure, you might not be familiar with HELLP syndrome, which is often considered to be a variant of preeclampsia. Like preeclampsia, HELLP can be a life-threatening complication of pregnancy, or less often, after giving birth.

According to Stanford Children’s Health, while exact statistics aren’t known, HELLP syndrome is thought to occur in 1 to 2 out of every 1,000 pregnancies, and in 10 to 20 percent of pregnancies where the mother has a diagnosis of severe preeclampsia.

It’s important to be aware of and recognize the symptoms in order for early diagnosis and treatment.

Helpful HELLP syndrome treatments
Illustration by Jessica Olah, Verywell.

Symptoms

HELLP syndrome typically occurs in the last trimester of pregnancy, but can also occur after childbirth. The name comes from certain characteristics of the condition: Hemolysis (breaking down of red blood cells), elevated liver enzymes, and low platelet count.

Symptoms can be general and tricky to diagnose at first, especially because the symptoms can mimic occurrences that typically occur in late pregnancy. Symptoms can include:

  • Fatigue
  • Fluid retention
  • Excessive weight gain
  • Headaches
  • Nausea or vomiting
  • Pain in upper right or middle of the abdomen
  • Blurry vision
  • Swelling of face and/or hands
  • High blood pressure
  • Protein in urine

Diagnosis

At every prenatal visit, you will submit a urine sample, which is checked for sugars and protein, and your blood pressure is taken to monitor for preeclampsia and other issues.

If you notice any symptoms or occurrences that seem out of the normal, tell your provider immediately.

HELLP can mimic preeclampsia at first, and your doctor will order blood tests if he or she suspects HELLP syndrome. If these blood tests show hemolysis, elevated liver enzymes, and low platelets, a diagnosis of HELLP is made. Protein in the urine might be present, but not always.

Causes

The exact cause of HELLP is unknown, although there are risk factors that might increase your risk. You can also develop HELLP syndrome without having any of the risk factors.

If you have any risk factors, this does not necessarily mean you’ll develop HELLP syndrome. It's just something to be aware of.

Risk factors include:

  • Having HELLP syndrome with a previous pregnancy
  • Being over the age of 25 years old
  • Being Caucasian
  • Having given birth at least twice before
  • Having a diagnosis of preeclampsia or pregnancy-induced hypertension

If you have any of these risk factors, talk with your doctor about your risk of developing HELLP, and what you should be watchful of.

There is no way to prevent HELLP, but regular prenatal visits are important and can help catch any concerning symptoms as soon as possible.

Treatment

Giving birth to the baby is the only definitive cure for HELLP syndrome, but depending on the time of gestation, this may not be the first-line treatment.

There are things that can be done to help treat HELLP while the fetus matures. Treatment can include:

  • Bedrest, either at home or in the hospital
  • Blood transfusions to treat the anemia and low platelet counts
  • Magnesium sulfate to prevent seizures
  • Blood pressure medications
  • Continuous fetal monitoring while in the hospital
  • Regular laboratory testing to monitor the progression of HELLP syndrome
  • Corticosteroids to help the lungs of the fetus develop in preparation for delivery

Prognosis

The prognosis for HELLP syndrome can vary, depending on whether it was found in time and treated. Left untreated, it can be fatal.

With appropriate treatment, outcomes are generally good for mom and baby. Typically, once the baby is born, symptoms in the mom generally start to improve within 48 hours.

For pregnant women, there are possible complications, and the risk of complications is generally increased depending on the severity of laboratory results. Complications can include placental abruption, kidney failure, and pulmonary edema, among others.

Prognosis for the baby generally depends on the gestational age of the baby at the time of delivery, as well as its birth weight, rather than HELLP syndrome itself.

This is why doctors will try to treat HELLP syndrome when possible, instead of simply delivering the baby, especially if the woman is not close to being full-term.

A Word From Verywell

If you’re pregnant and have risk factors for HELLP syndrome, talk with your doctor about your risk factors and concerns. He or she can let you know specific symptoms to watch out for and can help put you at ease about your pregnancy.

If you notice any symptoms out of the ordinary, or signs that might be related to high blood pressure or HELLP, call your doctor immediately. The sooner HELLP is identified, the sooner treatment can start.

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