Topic Overview

HELLP syndrome is a life-threatening liver disorder thought to be a type of severe pre-eclampsia. It is characterized by H emolysis (destruction of red blood cells), E levated L iver enzymes (which indicate liver damage), and L ow P latelet count.

HELLP is usually related to pre-eclampsia. About 10% to 20% of women who have severe pre-eclampsia develop HELLP.^{footnote 1} In most cases, this happens before 35 weeks of pregnancy, though it can also develop right after childbirth.^{footnote 1}

HELLP syndrome often occurs without warning and can be difficult to recognize. It can occur without the signs of pre-eclampsia (which are usually a large increase in blood pressure and protein in the urine). Symptoms of HELLP syndrome include:

• Headache.
• Vision problems.
• Pain in the upper right abdomen (liver).
• Shoulder, neck, and other upper body pain (this pain also originates in the liver).
• Fatigue.
• Nausea and vomiting.
• Seizure.

HELLP syndrome can be life-threatening for both the mother and her fetus. A woman with symptoms of HELLP syndrome requires emergency medical treatment.

Treatment and prognosis

Delivery is the only known way to reverse HELLP syndrome. Vaginal delivery is often possible, but a caesarean is used if the mother or fetus is not medically stable. Before delivery, treatment with medicines is used to:

• Prevent seizures, known as eclampsia (magnesium sulfate prevents seizures).
• Control severe high blood pressure.
• Develop the fetus's lungs if the pregnancy is less than 34 weeks along (corticosteroid injections are given to the mother).

Most women begin to recover from HELLP within a few days after delivery. But for some women, especially those who have had complications of HELLP, it can take longer. Your doctor will monitor your recovery.

After having HELLP syndrome, you are considered high-risk for complications during any future pregnancies. Make sure that your doctor knows about this part of your health history—you will require close monitoring during any pregnancy and postpartum period.