HELLP Syndrome

HELLP syndrome is a condition affecting pregnant women, characterized by a triad of hemolytic anaemia, elevated liver enzymes and low platelet count. It is invariably associated with high B.P during pregnancy.

HELLP syndrome is a rare disorder and is mostly asymptomatic till complications arise. It most commonly presents as pain in the right upper quadrant of the abdomen. This is believed to be due to the stretching of the pain sensitive capsule of the liver. Women also manifest nausea, vomiting, and headache. Blurring of vision may be an associated complaint.

Women may also manifest symptoms of anaemia due to the destruction of blood cells. Symptoms of anaemia typically include fatigue, breathlessness and effort intolerance.

Clinical exam of a woman with HELLP syndrome is likely to reveal high B.P, pale looking skin and mucosa and tenderness over the right upper quadrant of the abdomen.

The diagnosis of HELLP syndrome is a clinical one aided by laboratory findings of anaemia, reduced platelet count and elevated liver enzymes.

If left untreated it may can many complications prime among this is disseminated intra-vascular coagulation. DIC is a dangerous condition characterized by bleeding and formation of clots inside the body. The other major complications include pre- eclampsia, eclampsia, pre term labour and abortion. This syndrome may also cause bleeding within the parenchyma of the liver, leading to collection of blood underneath the capsule of the liver. This is known as hematoma of the liver and is a serious complication.

The treatment of HELLP syndrome follows that of hypertension during pregnancy. Women must be under bed rest and meticulous attention needs to be paid to the maternal and foetal health. Salt restricted diet is advised.

Blood and platelet transfusions may be necessary. There is no effective treatment for the elevated liver enzymes.

If the condition of the mother worsens then a decision to terminate the pregnancy in the interest of the mother should be considered strongly.

Since there are no predictive factors for HELLP syndrome, there are no specific measures suggested. The best for of prevention is awareness about this condition.

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