The acronym HELLP is an appropriate label for a rare but potentially deadly collection of symptoms that can drastically affect a pregnant woman and her baby. Women stricken with HELLP syndrome need a lot of urgent and effective help.
The original prehistoric division of labor seemed fairly simple. The men protected the tribe against their neighbors. They also banded together to hunt down mammoths, slay them, and drag the carcasses back to the cave. The women were tasked with turning the carcass into meals and bearing children.
Seems fairly equitable on the surface. But, as it turns out, childbearing can be a lot more complicated, difficult, and overwhelming than advertised.
Pregnancy causes radically transformational changes in a woman’s body
It’s sort of like turning a cozy bungalow into an automobile assembly line. Lots of things can go wrong during nine months of housing a continually developing fetus.
What is HELLP syndrome?
HELLP syndrome is one of the more serious things that can go awry during a pregnancy. The acronym is derived from three of the more serious symptoms that comprise HELLP syndrome.
1. H is for hemolysis in pregnancy
Hemolysis is a malfunction of your red blood cells. Those red blood cells are designed to carry oxygen throughout the body via your bloodstream.
The red blood cells of people with hemolysis lose the ability to deliver enough oxygen to the body. This can eventually lead to anemia. And anemia during pregnancy is associated with low birth weight, premature birth, and maternal mortality.
2. EL is for Elevated Liver enzymes in pregnancy
Your liver is as vital to your health as is your heart, or your lungs. The liver turns your dietary intake into usable substances and then distributes them throughout the body. Sort of like an Amazon warehouse.
The liver also scrubs toxins out of your bloodstream. Instead of filtering noxious material out of the blood, the livers of pregnant women with HELLP start leaking toxic chemicals back into the bloodstream.
3. LP stands for Low Platelet count in pregnancy
Platelets are the part of your blood that help it clot when necessary. Those with low platelet counts are in danger of excessive bleeding.
Diagnosing HELLP in pregnancy can be difficult
Some of the symptoms are quite similar to other, less scary conditions, like stomach flu. And most HELLP symptoms are identical to the symptoms of a pair of closely related conditions known as preeclampsia and eclampsia. In fact, many experts consider the three conditions to be on a spectrum that starts with preeclampsia.
In this analysis, HELLP is deemed to be a more severe form of eclampsia. A form of eclampsia that can cause seizures, strokes, and separation of the placenta from the wall of the uterus before the baby is born. Yikes.
Eclampsia and preeclampsia are both characterized by high blood pressure (hypertension). Most HELLP victims have high blood pressure, but about 15% of HELLP cases don’t include that symptom.
Other common HELLP symptoms are:
- General malaise or fatigue
- Pain in the upper abdomen, like heartburn
- Nausea/vomiting
- Headaches
- Swelling
- Weight gain
But almost all these symptoms are closely identified with a normal pregnancy, so it’s easy to see why misdiagnoses of HELLP are not uncommon.
When mental confusion and seizures are added to other HELLP symptoms, immediate evaluation by your doctor is strongly suggested.
Is there a test for HELLP?
Yes. Excessive protein in the urine is one symptom that can help diagnosticians to differentiate HELLP.
What causes HELLP syndrome?
The answer is simple but unsatisfying. Nobody knows. Some apparently associated risk factors include:
- Age over thirty-five
- Obesity
- High blood pressure that pre-existed the pregnancy
- Preeclampsia or eclampsia in a prior pregnancy
- An inherited genetic predisposition
Treatment of HELLP syndrome
The most effective treatment of HELLP syndrome is prompt delivery of the fetus. Eclampsia generally occurs during the third trimester, so a delivery immediately after the diagnosis is quite often possible.
When HELLP is diagnosed before immediate delivery is feasible, delaying tactics may include:
- Blood transfusions to deal with the anemia and low platelet levels
- Magnesium sulfate to prevent seizures
- Antihypertensive medication to control blood pressure
- Corticosteroid medication to accelerate the maturation of the baby’s lungs, in case an immediate delivery is mandated.
How to prevent HELLP
Another simple but disappointing answer. You can’t. You can’t prevent it because nobody knows what causes it. However, you can take care to maintain low blood pressure, minimize weight gain, and consume a healthy, iron-rich diet.
Be alert to the symptoms, and don’t hesitate to tell your doctor about those symptoms. Stay alert to the symptoms even after delivery, because postpartum HELLP is possible.
Some good news
HELLP is reassuringly rare. It occurs in well under 1% of American pregnancies. And prompt diagnosis, coupled with diligent monitoring, will almost always result in a healthy outcome for both mother and child.
About Dr. Thaïs Aliabadi
As one of the nation’s leading OB-GYNs, Dr. Thaïs Aliabadi offers the very best in gynecological and obstetric care. Together with her warm professional team, Dr. Aliabadi supports women through all phases of life. She fosters a special one-on-one relationship between patient and doctor.
We invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863-6700.
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Supported by her warm professional team, Dr. Aliabadi treats women through all phases of life and cherishes the special one-on-one relationship between patient and doctor.