HELLP syndrome is a serious complication during pregnancy. It can have life-threatening consequences for mother and child.
What is HELLP syndrome?
According to abbreviationfinder.org, the HELLP syndrome is one of the hypertensive disorders and occurs during pregnancy. The term HELLP syndrome is composed of the English terms of the three main symptoms: These are H for Hemolysis ( haemolysis ), EL for Elevated Liver Enzymes ( increase in liver values ) and LP for Low Platelets. This means that the number of thrombocytes (platelets) is too low.
HELLP syndrome is a serious form of preeclampsia. This disease, also known as pregnancy poisoning or gestosis, only occurs during pregnancy. The pregnancy complication becomes noticeable through disorders of blood coagulation and liver function and high blood pressure. In addition, increased protein levels are found in the urine.
The triggering causes of the HELLP syndrome are still unclear. The only reliable finding is a connection with processes in the placenta. From there, a signal is emitted that results in an increase in blood pressure in the affected woman. In some cases, this can affect the kidneys. In addition, certain diseases appear to play an important role in the development of HELLP syndrome.
These are primarily hepatitis, disorders of the immune system and chronic high blood pressure. A tendency to blood clots and genetic factors can also have a negative impact. According to another assumption, a hormonal imbalance is responsible for the HELLP syndrome. Prostaglandin E and thromboxane A play a part in this. These hormones, which belong to the prostaglandins, are tissue hormones that are produced in principle in all body cells.
While prostaglandin E widens the blood vessels and has an inhibiting effect on blood clotting, thromboxane A narrows the blood vessels and promotes blood clotting. If there is a disruption in the relationship between the two hormones, this results in negative changes in blood coagulation.
Symptoms, Ailments & Signs
Symptoms of the HELLP syndrome can appear within just a few hours. The first indications of the disease are swelling of the face and limbs, severe pain in the upper right abdomen, which is particularly severe when touched, blurred vision, nausea, vomiting and a general feeling of illness, which increases rapidly. In addition, increased protein is excreted in the urine.
Furthermore, the blood pressure of the pregnant woman increases to values of over 190/110 mmHg. However, some symptoms are often weak or not present at all. Problematically, swelling, nausea, and vomiting are common in pregnancy, so they don’t provide any concrete information.
In the worst case, however, the symptoms of HELLP syndrome can have life-threatening effects on mother and child. As a rule, HELLP syndrome develops in the last trimester of pregnancy. It usually shows up during the 34th week of pregnancy (GW).
Diagnosis & History
If HELLP syndrome is suspected, a diagnosis must be made as soon as possible. For this reason, the affected pregnant women are immediately referred to a hospital. There, the treating doctor first determines the medical history of the patient.
Existing pre-existing conditions such as diabetes mellitus, chronic high blood pressure, kidney diseases and previous stresses within the family are important.
Certainty that HELLP syndrome is present can only be obtained through laboratory tests. As part of the diagnostics, the blood coagulation parameters and liver values are determined. In addition, various examinations are carried out to monitor the course of the disease, such as a sonography (ultrasound examination) of the uterus.
The course of the disease of the HELLP syndrome is considered alarming. If hemolysis progresses, there is a risk of massive anemia. Internal bleeding is also a possibility. The longer the HELLP syndrome lasts, the greater the risk of damage to the liver cells. Particularly dangerous complications are detachment of the placenta, as well as acute renal failure.
The HELLP syndrome can lead to serious complications and discomfort for the child and the mother during pregnancy. In the worst case, both the mother and the child die. This primarily leads to a general feeling of illness on the part of the mother, with severe swelling of the face. Visual disturbances and vomiting with nausea continue to occur.
These complaints extremely reduce the quality of life of the patient. There is extreme pain in the upper abdomen, which occurs mainly when touched. In many cases, the HELLP syndrome is only diagnosed at a late stage, since the signs and symptoms are not unique to this disease. However, if left untreated, the syndrome can have a very negative impact on the child’s health. Internal bleeding and kidney failure can also occur. In this case, the patient is dependent on dialysis.
As a rule, no treatment of the HELLP syndrome is possible. For this reason, the birth has to be carried out earlier, which in most cases leads to discomfort and complications. It is not possible to make a general prediction about the success of the birth. The child may not be born completely healthy.
When should you go to the doctor?
Since the HELLP syndrome can, in the worst case, lead to both the death of the mother and the death of the child, medical treatment and examination should always be carried out. As a rule, a doctor should be consulted if the pregnant woman’s face swells up a lot or if there is severe pain in the upper area of the abdomen. Furthermore, visual disturbances or nausea with vomiting can indicate the HELLP syndrome and should be examined by a doctor.
Since these symptoms can also occur during pregnancy without HELLP syndrome, an examination is still recommended if they occur. High blood pressure can also indicate this symptom. First and foremost, the pregnant woman should see a gynecologist. This can determine the HELLP syndrome. In acute emergencies or in the case of very severe symptoms, however, you should go to the hospital or call an ambulance. Early diagnosis and treatment can save the life of the child and the mother.
Treatment & Therapy
The treatment of HELLP syndrome depends on when the disease occurs. If it appears after the 34th week of pregnancy, the birth of the child must be initiated. On the other hand, if the syndrome occurs before the 32nd week of pregnancy, doctors delay the birth process for as long as possible. This is urgently required for the maturation of the child’s lungs. Drugs are used to stabilize the mother’s blood clotting and blood pressure.
It is important to lower blood pressure in a controlled manner to prevent damage to the placenta. For this reason, a CTG control is always carried out, in which a special contraction recorder checks the mother’s contractions on the one hand and the heart activities of the child on the other. However, a delayed delivery can only be carried out if the blood coagulation values, blood pressure and liver values have returned to normal. The later the birth can be induced, the higher the child’s chances of survival.
To support lung maturation, the child also receives cortisone or cortisone-like preparations. In order to be able to intervene quickly in an emergency, mother and child are monitored around the clock. If the HELLP syndrome is only mild, it is sometimes possible to wait without inducing the birth. However, strict controls of the mother’s blood pressure and blood values are important.
Outlook & Forecast
The HELLP syndrome is a serious complication during pregnancy and can lead to serious consequential damage. Close medical monitoring of mother and child is required in order to be able to intervene quickly in an emergency.
First, severe anemia with all the symptoms can occur in the pregnant woman. As a result, internal bleeding often cannot be ruled out, since the number of platelets drops massively. At best, this bleeding is so minimal that it goes unnoticed, but bleeding with symptoms can also occur.
The longer the HELLP syndrome lasts, the further the damage to the liver cells of the pregnant woman progresses. As a result, more or less large hematomas form under the liver capsule, which are usually easy to see on ultrasound. In an emergency, this can lead to a liver rupture, which requires immediate surgery and can be life-threatening. The HELLP syndrome can also lead to severe kidney damage and even acute kidney failure.
All of this affects the unborn child at most through the necessary medication and surgical interventions on the mother. It becomes dangerous for the baby if the placenta detaches prematurely as a result of the HELLP syndrome. This can not only happen during childbirth, but also unexpectedly beforehand during the course of pregnancy.
In order to be able to recognize the HELLP syndrome in good time and treat it accordingly, antenatal care should be carried out consistently. This is done by regularly measuring blood pressure, checking urine output and examining kidney and liver functions.
In most cases, the measures and options for aftercare in HELLP syndrome are severely limited. Here, the person concerned is first dependent on a quick diagnosis with subsequent treatment in order to prevent further complications. In the worst case, this can lead to the death of the child or the mother, so that early detection of the disease is paramount in the case of HELLP syndrome.
As a rule, there are hardly any aftercare options, since the further course depends heavily on the birth of the child. Regular examinations of the child and the mother are necessary to properly monitor the situation. After birth, the child is usually dependent on taking medication.
Parents have to pay attention to the correct dosage and regular intake. Regular check-ups by a doctor are also necessary after the birth. Parents depend on the support of family and friends to prevent mental upset or depression. Loving care and support have a positive effect on the course of the disease. It cannot generally be predicted whether the HELLP syndrome will result in a reduced life expectancy for the child or for the mother.
You can do that yourself
HELLP syndrome always represents a medical emergency that requires immediate medical attention. If poisoning is suspected, go to the hospital immediately, as there is a real danger to life for both the mother and the child. Independent treatment far away from conventional medicine is strongly discouraged. Otherwise, there is a risk of an unnecessary aggravation of the situation, which can lead to irreversible damage to health.
In the majority of cases, the life of both mother and child can only be saved by delivering the baby via caesarean section. However, this does not yet lead to an interruption of the HELLP syndrome. The climax often occurs after the initiation of labor. Comprehensive aftercare is all the more important.
In addition to the physical care of mother and child, mental care must also be taken into account. Often years later, the affected woman still has psychological after-effects. Psychotherapeutic support helps to process the traumatic experience, to avoid long-term impairments and to cope with everyday life.