HELLP Syndrome in Pregnancy

Posted by Healthfitline On Friday, March 1, 2013
HELLP Syndrome is a serious variation of pregnancy induced hypertension, characterized by hemolysis, elevated liver enzymes and low plateletes. The word HELLP is derived from these four common symptoms.

Causes of HELLP Syndrome
The cause of HELLP syndrome is unknown but atleast 4% to 12% of patients diagnosed with HELLP syndrome also suffer from pregnancy induced hypertension.  In some women, it  develop once PIH progresses to severe form of pre-eclampsia.  HELLP syndrome is usually misdiagnosed due to the similarities of the presenting symptoms with symptoms of other diseases, like hepatitis and other bleeding disorders.

HELLP Syndrome Risk Factors
  • Pregnant women with a previous history of HELLP Syndrome.
  • PIH - pregnancy induced hypertension
  • Race - more common in Caucasian women.
  • More common in women have previously given birth than first time mothers.
Signs and Symptoms of HELLP Syndrome
  • Headache
  • Body malaise or fatigue
  • Flu like symptoms
  • Epigastric pain (middle region of the abdomen below the sternum).
  • Nausea and vomiting
  • Pain and tenderness in the right side of the upper abdomen region (liver inflammation).
HELLP Syndrome Diagnostic Tests
  • Physical Examination - palpation to detect the liver size.
  • Liver Function tests  - reveals elevated liver enzymes; alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST).
  • Laboratory Blood Tests - reveal hemolysis of the red blood cell, a low platelets counts below 100,000/mm3.
  • Test to measure the level of bilirubin.
HELLP Syndrome Treatment
The best treatment of HELLP syndrome is to deliver the fetus as soon as possible. If the fetus is still very immature and the lung has not matured, the mother is given corticosteroids to fasten the fetal lung maturity. Delivery is then postponed for a few more days and the mother is closely monitored for bleeding and pre-eclampsia. As soon as the baby lung is mature, he or she is delivered by vaginal birth or cesarean.  Symptoms of HELLP syndrome usually subside after delivery without further complication.

In addition to close monitoring, other medications and therapies that may be given to HELLP syndrome patient may include;
  • Platelet transfusion - to increase the platelet levels in the blood.
  • Medications to treat hypertension.
  • Seizure precautions (possibilities of developing eclampsia).
  • Fetal monitoring tests like sonogram, non stress and biophysical tests.
  • Best rest may also be recommended.
HELLP Syndrome Complications
Possible complications associated with HELLP syndrome include;
  • Liver hematoma (formation of liver clots).
  • Decreased sodium levels
  • Renal Failure
  • Decreased blood glucose
  • DIC (disseminated intravascular coagulation) due to low platelet counts.
  • Maternal hemorrhage during birth due to poor clotting ability.
HELLP Syndrome Prevention
Though there is no way you can prevent yourself from acquiring HELLP syndrome but seeking medical advise early in the course or having a regular prenatal check up will help your doctor to detect such problems early enough and treat them before they can develop to serious complication. Exercises, proper diet, bed rest may also help in lowering the blood pressure but always seek medical advise before you can start any exercie or diet.
 

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