What Is HELLP Syndrome?

Everything you need to know about HELLP syndrome—a rare but serious pregnancy complication.
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Chances are you've heard of preeclampsia, but are you familiar with HELLP syndrome? Like preeclampsia, HELLP syndrome is a potentially life-threatening pregnancy disorder related to blood pressure. It can occur at any gestational age or even after birth, with or without a prior diagnosis of preeclampsia. But most often, HELLP syndrome develops in the third trimester and in connection with preeclampsia. In fact, an estimated 5 to 12 percent of preeclamptic women will develop this more serious disorder.

Check out our guide to HELLP syndrome so you can learn the symptoms and have a safer pregnancy.

What is HELLP syndrome?
HELLP stands for Hemolysis (a break down of red blood cells), ELevated liver enzymes, and Low Platelet count, and it can lead to serious liver damage. Although HELLP shares many of the same symptoms with preeclampsia, such as high blood pressure and protein in the urine, it can develop more quickly -- even before these symptoms are apparent. The Preeclampsia Foundation reports that almost 50,000 women in the United States develop HELLP syndrome each year. "It's long been known that preeclampsia can affect the liver and blood clotting, but in 1982, relatively recently, the constellation of these three findings was identified as a unique subset of severe preeclampsia," says Ira Bernstein, M.D, professor of obstetrics and gynecology at the University of Vermont College of Medicine.

What are the risk factors for HELLP syndrome?
There are no specific known risk factors for HELLP, but it often develops in conjunction with preeclampsia. Of the 5 to 8 percent of pregnant women in the United States who develop preeclampsia, up to 12 percent will show signs of HELLP syndrome. So if you're at risk of preeclampsia -- you or others in your family have a history of the condition; you're over 40, obese, pregnant with multiples, having babies less than 2 years apart or more than 10 years apart; or you have a history of high blood pressure, migraines, type 1 or 2 diabetes, kidney disease, blood clots or lupus -- it's especially important to know the signs of HELLP syndrome.

What are the signs and symptoms of HELLP syndrome?
"HELLP is insidious because it's very hard to detect and diagnose without lab testing," says James N. Martin, M.D., past president of the American College of Obstetricians and Gynecologists.

Still, there are important signs and symptoms to be aware of. If you notice any of the following during your pregnancy or at any point postpartum, see your doctor right away:

  • Headache, especially if it's significant and persistent and isn't relieved by acetaminophen (Tylenol)
  • Late pregnancy nausea and vomiting
  • Upper abdominal or chest pain that worsens
  • Shoulder pain or pain when breathing deeply
  • Changes in vision
  • Swelling, particularly in the legs

What can HELLP syndrome mean for my baby and me?
Sadly, HELLP syndrome can be fatal for moms: According to the Preeclampsia Foundation, maternal deaths from HELLP may be as high as 25 percent, because the condition can lead to multiple organ failure.

Babies are also at risk, especially those who weigh less than 2 pounds at delivery. Research shows that these babies will likely need longer hospitalization and treatment with a ventilator because of complications related to HELLP.

Treatment and prevention of HELLP syndrome
Unfortunately, there are no known preventative strategies for HELLP syndrome, says Dr. Bernstein. Once you have the condition, at any gestational age, delivering your baby is indicated, although it can sometimes be delayed for a day or two to enable the mother to receive steroids to help prepare the baby for preterm birth, says Dr. Martin. "The triple therapy used for most patients is control of blood pressure to prevent stroke, prevention of seizures with magnesium sulfate, and halting further progression of the disease with steroids."

Postpartum treatment for HELLP syndrome consists of symptomatic support -- medications to lower blood pressure and blood replacement products, if necessary.

"It's important that women and their physicians are aware of symptoms and report them as soon as possible," says Dr. Martin. Because HELLP is considered a unique form of preeclampsia, be as careful as you can with diet and exercise and have your blood pressure monitored if it's known to be high.

Swelling is a common side effect of pregnancy as your due date gets closer. Learn how to get relief and when you need to call a doctor.

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