HELLP syndrome

Some pregnant women with high blood pressure develop a condition called HELLP syndrome. HELLP stands for these blood and liver problems:

  • H--Hemolysis. This is the breakdown of red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body.
  • EL--Elevated liver enzymes. High levels of these chemicals can be a sign of liver problems.
  • LP--Low platelet count. Platelets help the blood clot.

HELLP syndrome is rare but serious. It happens in about 1 to 2 of 1,000 pregnancies. About 2 in 10 pregnant women (20 percent) with preeclampsia or eclampsia have HELLP. Preeclampsia is a condition that can happen after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Some of these signs include having protein in the urine, changes in vision and severe headache. Elcampsia is a condition that follows preeclampsia and causes seizures during pregnancy.

What are the signs and symptoms of HELLP syndrome?

Signs and symptoms can appear during pregnancy or after giving birth. Most women with HELLP have signs and symptoms before 37 weeks of pregnancy. But some women don’t have them until the week after they give birth.

Signs and symptoms include:

  • Blurry vision
  • Fatigue (feeling really tired)
  • Quick weight gain and swelling
  • Headache
  • Nausea or throwing up
  • Nosebleed or other bleeding that doesn’t stop easily
  • Seizures
  • Upper belly pain

If you have any of these signs or symptoms, call your health care provider or go for medical care immediately.

How is HELLP syndrome diagnosed?

Your provider does a physical exam to check you for:

  • Belly pain or soreness, especially in the upper right side
  • Enlarged liver
  • High blood pressure
  • Swelling in your legs

Your provider also may use a liver function test to check your liver enzyme levels or blood tests to check your platelet count. A CAT scan can show bleeding into the liver. A CAT scan is a test that uses X-rays and computers to take pictures of your body.

Many women are diagnosed with preeclampsia before they have HELLP. Sometimes HELLP symptoms are the first sign of preeclampsia.

How is HELLP syndrome treated?

If you have HELLP, your provider may give you medicine to control your blood pressure and prevent seizures. Sometimes women also need a blood transfusion. This is when you have new blood put into your body.

Women who have HELLP syndrome almost always need to give birth as soon as possible, even if the baby is born prematurely, before 37 weeks of pregnancy. Early birth is necessary because HELLP complications can get worse and harm both mom and baby.

If you have HELLP syndrome, your provider may give your corticosteroid medicines to help speed your baby’s lung growth. He also may induce your labor. This means he gives you medicines to make labor begin. Some women need a cesarean section (c-section). A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

Without early treatment, 1 out of 4 women (25 percent) with HELLP syndrome has serious complications. Without any treatment, a small number of women die.

What causes HELLP syndrome?

We don’t know what causes HELLP. But if you’ve had it before, you may have it again in 1 out of 4 future pregnancies (25 percent).

You may be able to reduce your risk of having HELLP syndrome by getting prenatal care early and throughout your pregnancy. Getting regular prenatal care allows your provider to find and treat any problems like HELLP early.

Last reviewed: April, 2013