HELLP syndrome is a group of symptoms that occur in pregnant women suffering from hemolysis, elevated liver enzymes and decreased platelets. It takes its name from the acronym of these symptoms in English ("hemolysis", "elevated liver enzymes" and "low platelet count".
It is a very unusual syndrome that was first described as such by Louis Weinstein in 1982, who three years later would classify it as a variant of severe preeclampsia that can develop before birth.
This syndrome occurs in approximately one to two out of every thousand pregnancies, although in women with preeclampsia or eclampsia, the condition develops between 10% and 20% of pregnancies.
Almost always, HELLP syndrome occurs during the third trimester of pregnancy and sometimes it manifests itself in the week after the baby is born.
Symptoms of HELLP syndrome in pregnancy
Symptoms of HELLP syndrome in pregnancy they can be: fatigue or discomfort; fluid retention and excess weight gain (recent); headache; nausea and vomiting that continue to get worse; pain in the right upper quadrant or middle abdomen; and blurred vision. More rarely, nasal bleeding or other bleeding occurs that does not stop easily, seizures or seizures.
According to the Spanish Society of Gynecology and Obstetrics, the first symptoms are usually digestive: pain in the epigastrium or right hypochondrium (90% of the cases), in a pregnant woman who in more than 90% of the cases notice indefinite discomfort from a few days before going to the doctor.
At first, hypertension and proteinuria can be mild or even absent, so sometimes the diagnosis is delayed. That is why it is recommended that liver tests and a platelet count be performed in every pregnant woman who presents with the above symptoms, whether or not she has hypertension.
HELLP syndrome can cause postpartum hemorrhage, as it is among the causes by altering coagulation.
When a HELLP syndrome is diagnosed or suspected, the pregnant woman should be transferred to a hospital for monitoring and possible treatments, stabilization will be attempted and the action that follows will depend on the severity of the symptoms. Normally, the decision to end the pregnancy has to be taken once the fetal lung maturity has been verified, that is, if the baby is more or less prepared to be born and survive.
Complications of HELLP syndrome
The results are often good if the problem is diagnosed early, so remember the importance of having regular prenatal checkups and not letting the described symptoms pass.
When the disease is not treated in a timely manner, up to one in four women affected has serious and untreated complications, a small number of women die. The mortality rate among babies born to mothers with HELLP syndrome depends on the birth weight and the development of the baby's organs, especially the lungs, as many babies are born prematurely.
Between HELLP syndrome complications they are: pulmonary edema, renal insufficiency, liver failure and hemorrhage and separation of the placenta from the uterine wall (premature placental abruption). In some severe cases (as if disseminated intravascular coagulation or DIC occurs, a disorder in which the proteins that control blood clotting become too active), pregnancy should be terminated regardless of the time of pregnancy.
However, in general the diagnosis of HELLP syndrome does not imply an emergency C-section, a decision that could be dangerous for the mother or the fetus. Each case must be assessed particularly.
We repeat that the important thing is to carry out the checks during pregnancy and not let the suspicious symptoms pass, in this way a possible case of HELLP syndrome during pregnancy, which are rare, will be diagnosed on time and controlled without serious consequences.
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In Babies and more | HELLP syndrome, hypertensive states of pregnancy
