HELLP syndrome

Also known as HELLP syndrome (disorder), syndrome of haemolysis, elevated liver enzymes and low platelet

severe pre-eclampsia characterized by hemolysis, elevated liver enzyme and low platelet count

Key facts

Specialty: Obstetrics
Symptoms: Feeling tired, retaining fluid, headache , nausea, upper abdominal pain , blurry vision, seizures
Complications: Disseminated intravascular coagulation (DIC), placental abruption , kidney failure , pulmonary edema
Usual onset: Last 3 months of pregnancy or shortly after childbirth
Types: Complete, incomplete
Causes: Unknown
Risk factors: Preeclampsia , eclampsia , previously having HELLP, mother older than 25 years
Diagnostic method: Blood tests
Differential diagnosis: Viral hepatitis , thrombotic thrombocytopenic purpura , cholangitis , hemolytic uremic syndrome
Treatment: Delivery of the baby as soon as possible, management of blood pressure
Prognosis: <1% risk of death (mother); 7.3% to 11.9% risk of death (child)

~13 min read

Article

HELLP syndrome is a complication of pregnancy; the acronym stands for hemolysis, elevated liver enzymes, and low platelet count. It usually begins during the last three months of pregnancy or shortly after childbirth. Symptoms may include feeling tired, retaining fluid, headache, nausea, upper right abdominal pain, blurry vision, nosebleeds, and seizures. Complications may include disseminated intravascular coagulation, placental abruption, and kidney failure.

The cause is unknown. The condition occurs in association with pre-eclampsia or eclampsia. Other risk factors include previously having the syndrome and a mother older than 25 years. The underlying mechanism may involve abnormal placental development. Diagnosis is generally based on blood tests finding signs of red blood cell breakdown (lactate dehydrogenase greater than 600 U/L), an aspartate transaminase greater than 70 U/L, and platelets less than 100×10/l. If not all the criteria are present, the condition is incomplete.