Pregnancy Induced Hypertension: Symptoms of HELLP Syndrome

Pregnancy Induced Hypertension
The HELLP syndrome is a serious complication in pregnancy characterized by hemolysis, elevated liver
enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe
preeclampsia. The present review highlights occurrence, diagnosis, complications, surveillance, and
corticosteroid treatment, mode of delivery and risk of recurrence.
HELLP syndrome was named by Dr. Louis Weinstein in 1982 after its characteristics:
H (hemolysis, which is the breaking down of red blood cells)

EL (elevated liver enzymes)
LP (low platelet count)
HELLP syndrome can be difficult to diagnose, especially when high blood pressure and protein in the urine
aren't present. Its symptoms are sometimes mistaken for gastritis, flu, acute hepatitis, gall bladder disease, or
other conditions.
The global mortality rate of HELLP syndrome has been reported to be as high as 25%. That's why it's critical for
expecting mothers to be aware of the condition and its symptoms so they can receive early diagnosis and
treatment.
The severity of HELLP syndrome is measured according to the blood platelet count of the
mother and divided into three categories, according to a system called "the Mississippi
classification."
 Class I (severe thrombocytopenia): platelets under 50,000/mm3
 Class II (moderate thrombocytopenia): platelets between 50,000 and 100,000/mm3
 Class III (AST > 40 IU/L, mild thrombocytopenia): platelets between 100,000 and 150,000/mm3
Symptoms of HELLP Syndrome:

The physical symptoms of HELLP Syndrome may seem at first like preeclampsia. Pregnant women developing
HELLP syndrome have reported experiencing one or more of these symptoms:
 Headache
 Nausea/vomiting/indigestion with pain after eating
 Abdominal or chest tenderness and upper right upper side pain (from liver distention)
 Shoulder pain or pain when breathing deeply
 Bleeding
 Changes in vision
 Swelling
Signs to look for include:

 High blood pressure
 Protein in the urine
The most common reasons for mothers to become critically ill or die are liver rupture or stroke (cerebral
edema or cerebral hemorrhage). These can usually be prevented when caught in time. If you or someone you
know has any of these symptoms, please see a healthcare provider immediately.
Treatment of HELLP Syndrome:
Most often, the definitive treatment for women with HELLP Syndrome is the delivery of their baby. During
pregnancy, many women suffering from HELLP syndrome require a transfusion of some form of blood product
(red cells, platelets, plasma). Corticosteroids can be used in early pregnancy to help the baby's lungs mature.
Some healthcare providers may also use certain steroids to improve the mother's outcome, as well.
Who's at Risk of Getting HELLP Syndrome?
Among pregnant women in the United States, 5 to 8% develop preeclampsia. It's estimated that 15% of those
women will develop evidence of HELLP syndrome. These mean as many as 48,000 women per year will
develop HELLP syndrome in the US.
We can help lower the cases of HELLP syndrome by properly and quickly diagnosing and treating
preeclampsia.
What Can I Do to Prevent HELLP Syndrome?

Unfortunately, there's currently no way to prevent this illness. The best thing to do is:
 Get yourself in the good physical shape before getting pregnant
 Have regular prenatal visits during pregnancy
 Inform your care providers about any previous high-risk pregnancies or family history of HELLP
syndrome, preeclampsia, or other hypertensive disorders
 Understand the warning signs and report them to your healthcare provider immediately
 Trust yourself when "something just doesn't feel right"
Babies Born To Mothers with HELLP…
The main danger to a baby born to a mother with HELLP, is being born prematurely (before week 37 of
pregnancy). Premature babies have less time to develop, so they can find it hard to breathe on their own.
They may need to stay in a neonatal intensive care unit for close supervision. If the baby weighs less than 3.5
pounds (1,500 g), they have a 1 in 6 chance of dying before their first birthday.
In developed countries, the stillbirth rate (in utero death of the baby after 20 weeks) is 51 out of every 1,000
pregnancies. This rate is higher than both severe preeclampsia and eclampsia.
Overall perinatal mortality from HELLP Syndrome (stillbirth plus neonatal death) ranges from 7.7 to 60%. Most
of these deaths are attributed to abruption of the placenta (placenta prematurely separating from the uterus),
placental failure with intrauterine asphyxia (fetus not getting enough oxygen), and extreme prematurity.

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Pregnancy Induced Hypertension

H (hemolysis, which is the breaking down of red blood cells)

 Class II (moderate thrombocytopenia): platelets between 50,000 and 100,000/mm3

Symptoms of HELLP Syndrome:

Signs to look for include:

Treatment of HELLP Syndrome:

Who's at Risk of Getting HELLP Syndrome?

What Can I Do to Prevent HELLP Syndrome?

 Get yourself in the good physical shape before getting pregnant

 Have regular prenatal visits during pregnancy

 Trust yourself when "something just doesn't feel right"

Babies Born To Mothers with HELLP…

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