HELLP Syndrome in Pregnancy

The word 'HELLP' is an initialism for Hemolytic anemia, Elevated liver enzymes and Low Platelet count. HELLP syndrome was first diagnosed by Dr. Louis Weinstein in the year 1982. HELLP syndrome in pregnancy is a life-threatening complication that is considered to be a variation of pre-eclampsia. This complication generally arises during the later stages of pregnancy, that is, around the third trimester or even immediately after childbirth.

Causes
There is no known cause of this life-threatening complication. Some people claim that women that have a family history of HELLP syndrome may be more susceptible to it. Furthermore, women that have had a previous pregnancy wherein they suffered from HELLP syndrome may be more likely to suffer from it in their next pregnancy as well. Women that also had pre-eclampsia during pregnancy also have a tendency to suffer from this complication. Also, women who have late pregnancies, who are obese and who also have blood pressure problems are likely to suffer from HELLP syndrome during pregnancy. In general, most of the effects of HELLP syndrome are due to an aftermath of the activation of the coagulation cascade in the body.

Symptoms
Often women who suffer from HELLP syndrome have gestational hypertension, that is, high blood pressure during pregnancy. They may also be suspected of developing pre-eclampsia. Thus, HELLP syndrome in pregnancy has an onset with headaches, malaise, blurry vision, nausea and vomiting, pain around the upper abdomen, excessive weakness, etc. The excessive weakness and pallor is usually due to the hemolytic anemia. There may also be paresthesia and edema present. The hypertension, though diagnostic in nature, may be mild. If the high blood pressure is severe, then it may even lead to rupture of blood vessels, due to which there may be a hematoma. If there is a seizure or if the patients slips into a coma, then it means that the condition has progressed to eclampsia. There may even be disseminated intra-vascular coagulation and if treatment is not meted out in time, there may also be acute renal failure.

Treatment
The treatment for HELLP syndrome will depend on many factors like the health of the patient, the trimester of the pregnancy, medical history of the patient, severity of symptoms, etc. In most cases, there is need for hospitalization so as to keep the patient under observance. Although administration of drugs also help, it is not sure as to what drugs can be given at this stage to reverse the symptoms. Mostly, anti-hypertensive medication is given to keep the blood pressure under control. It is said that the administration of magnesium sulfate helps to prevent the occurrence of seizures. If the symptoms are severe, to the extent that they place the health of the mother and the baby in danger, then the treatment for HELLP syndrome in pregnancy consists of early delivery of the baby.

This is a serious complication that is seen in around 0.2 to 0.6% of all pregnancies. Many doctors tend to misdiagnose this condition in its early stages, due to which there may be an increase in the chances of liver or renal failure and thus, the overall morbidity rate. Thus, when it comes to HELLP syndrome, early identification of the symptoms helps prevent the chances of life-threatening complications towards the late stages. For this purpose, patient education about the possibilities surrounding this condition are very important so as to prevent the occurrence and worsening of this disease.