HELLP Syndrome and Preeclampsia

HELLP Syndrome and Preeclampsia

Topic Overview

HELLP syndrome is a life-threatening liver disorder thought to be a type of severe preeclampsia. It is characterized by H emolysis (destruction of red blood cells), E levated L iver enzymes (which indicate liver damage), and L ow P latelet count.

HELLP is usually related to preeclampsia. About 10% to 20% of women who have severe preeclampsia develop HELLP.footnote 1 In most cases, this happens before 35 weeks of pregnancy, though it can also develop right after childbirth.footnote 1

HELLP syndrome often occurs without warning and can be difficult to recognize. It can occur without the signs of preeclampsia (which are usually a large increase in blood pressure and protein in the urine). Symptoms of HELLP syndrome include:

  • Headache.
  • Vision problems.
  • Pain in the upper right abdomen (liver).
  • Shoulder, neck, and other upper body pain (this pain also originates in the liver).
  • Fatigue.
  • Nausea and vomiting.
  • Seizure.

HELLP syndrome can be life-threatening for both the mother and her fetus. A woman with symptoms of HELLP syndrome requires emergency medical treatment.

Treatment and prognosis

Delivery is the only known way to reverse HELLP syndrome. Vaginal delivery is often possible, but a cesarean is used if the mother or fetus is not medically stable. Before delivery, treatment with medicines is used to:

  • Prevent seizures, known as eclampsia (magnesium sulfate prevents seizures).
  • Control severe high blood pressure.
  • Develop the fetus's lungs if the pregnancy is less than 34 weeks along (corticosteroid injections are given to the mother).

Most women begin to recover from HELLP within a few days after delivery. But for some women, especially those who have had complications of HELLP, it can take longer. Your doctor will monitor your recovery.

After having HELLP syndrome, you are considered high-risk for complications during any future pregnancies. Make sure that your doctor knows about this part of your health history—you will require close monitoring during any pregnancy and postpartum period.

Related Information

References

Citations

  1. Habli M, Sibai BM (2008). Hypertensive disorders of pregnancy. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 257–275. Philadelphia: Lippincott Williams and Wilkins.

Credits

Current as of: February 11, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
William Gilbert MD - Maternal and Fetal Medicine

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