HELLP Syndrome

HELLP Syndrome is a serious complication of pre-eclampsia but is very uncommon

What is HELLP Syndrome and how can you spot it?

HELLP Syndrome is one of the most serious complications of pre-eclampsia. It is important to remember that it is very uncommon. It affects less than 1% of pregnancies but it can be life threatening if not diagnosed and treated early.

It’s linked to pre-eclampsia and  is named after the parts of the body it affects:

H= Haemolysis (red blood cells can rupture)

EL= Elevated Liver enzymes (leading to liver damage)

LP= Low Platelets in the blood (blood doesn’t clot properly).

What are the symptoms of HELLP?

HELLP is treatable if spotted early, so being aware of the symptoms is important. Symptoms of pre-eclampsia might develop first, so a swollen face, feet or hands, high blood pressure or protein in urine are early signs, but just like eclampsia, HELLP can develop out of nowhere with no advanced warning. Symptoms of HELLP include:

  • Serious pain just below the ribs
  • Acute pain on the upper right side of the chest area (where the liver is)
  • Shoulder pain or pain when breathing.
  • Vomiting
  • Headaches (problems with vision, such as blurring or flashing before the eyes) 
  • Feeling very unwell

Because of the location of the pain it can sometimes be confused with heart-burn, but the pain isn’t actually a burning feeling, it doesn’t travel up to the throat and antacid tablets won’t get rid of it. Again, because of the location, doctors may diagnose gall bladder conditions or other problems linked to severe abdominal pain.

If a doctor suspects HELLP then a range of blood tests will be done to make a firm diagnosis.

When should I look out for it?

HELLP usually develops during the second half of pregnancy and is most likely just after delivery (just like eclampsia). It has been known to happen earlier on in pregnancy, but this is rare.

What happens if I develop HELLP?

HELLP causes certain parts of the body to stop functioning properly and can be fatal if left untreated. The most common risks of HELLP are:

  • Liver rupture or even liver failure
  • Kidney failure
  • Acute breathing difficulties
  • Serious loss of blood (particularly after surgery because the blood is not clotting as it should do)

How is it treated?

Delivering the baby as soon as possible is the best agreed treatment because of the risk to the mother but experts are still undecided about the best thing to do if the pregnancy hasn’t reached 34 weeks yet. If the mother isn’t critically ill, doctors may try to keep her stable while giving steroids to the unborn baby to help to mature its lungs. After delivery the woman’s liver, lungs and kidneys may need to be supported in hospital until her body recovers from the illness.

Women can recover from HELLP as quickly as 2-3 days, or may take up to 3 months to be fully recovered.  Around 1% of cases can be fatal for the mother, usually because HELLP Syndrome wasn’t diagnosed early enough.

Will it affect my baby?

The syndrome itself doesn’t affect unborn babies, but, just like with pre-eclampsia, the lack of blood flowing through the placenta may affect the growth of the unborn child. The main effect on the baby will be the impact of an early delivery. Due to the risk to the mother’s life, in some cases babies have to be delivered too prematurely to survive. Babies born early to mothers affected by HELLP may experience the same health issues and developmental delays associated with any other premature birth.

How can I avoid getting it?

As it’s not really known what causes HELLP (or pre-eclampsia) to develop, there’s nothing specific you can do to avoid developing either of these. However, health experts recommend staying healthy before and during pregnancy, telling your GP of any family history of pre-eclampsia and making sure you have all the pre-natal checks available: You can look out for most of the symptoms yourself, but the key signs of high blood pressure and protein in your urine will be tested at those checks.

Will I get it again?

The chances of developing HELLP again in a further pregnancy are thought to be around one in 20. Many women who suffered with HELLP first time round are advised to take a daily aspirin when carrying a second child and have gone on to have a trouble-free pregnancy. Speak to your doctor if you are considering another baby – they may be able to refer you to a consultant who specialises in dealing with pre-eclampsia cases.

If you want more information and support concerning HELLP or pre-eclampsia see preeclampsia.org or contact action on pre-eclampsia.org.uk

HELLP Syndrome