HELLP syndrome, also considered a possible variant of preeclampsia, is a life-threatening complication that usually occurs during pregnancy’s later stages or even up to a week after childbirth.
The acronym HELLP describes what happens to women when the syndrome occurs: H (hemolysis, the breakdown of red blood cells), EL (elevated liver enzymes), and LP (low platelet count).
HELLP syndrome symptoms include fatigue, malaise, fluid retention, or weight gain. Other common symptoms can include headache, worsening nausea or vomiting, nose or other persistent bleeds, upper abdominal pain, blurry vision or, rarely, convulsions or seizures. Women with these symptoms might be misdiagnosed with the flu, gallbladder disease, hepatitis, or other illnesses.
Doctors examining women for HELLP look for such signs as swollen legs, abdominal tenderness, enlarged liver, and high blood pressure. While the cause of HELLP remains unknown, the syndrome is relatively rare. The American Congress of Obstetricians and Gynecologists estimates it occurs in 1-2 of every 1,000 pregnancies and in 10-20 percent of pregnant women who have severe preeclampsia or eclampsia.
HELLP syndrome is a serious complication of high blood pressure in pregnancy and must be treated immediately. For women who develop HELLP syndrome before 32 weeks, there are some doctors who can treat some women conservatively with blood pressure control medications. This must be done in a certain type of hospital setting.
In most cases, however, the treatment requires delivering the baby, even if it’s premature. This is done to prevent complications from the syndrome, which can include liver rupture or stroke, and put the mother and baby in danger. As many as a quarter of the women who do not receive timely treatment for the syndrome develop serious complications or die. Fetuses are at risk for complications related to problems with the placenta, lack of oxygen, and extreme prematurity. Women who have had the syndrome are at higher risk to get it in future pregnancies.
There is no known way to prevent HELLP syndrome, but pregnant women can avoid health problems and complications with early and consistent prenatal care. Women who have preeclampsia should be sure to go to their office visits and follow all the recommendations as it has been shown to be a possible precursor to HELLP syndrome.
Reviewed by Dr. Jen Lincoln, April 2020
- HELLP syndrome usually occurs in the third trimester of pregnancy but can occur soon after delivery.
- Women with HELLP syndrome have hemolysis, or the breakdown of red blood cells; elevated liver enzymes; and low platelet counts.
- HELLP syndrome occurs in up to 20 percent of pregnant women with severe preeclampsia or eclampsia.