What Causes HELLP Syndrome?

HELLP is an acronym that describes the features of a potentially deadly emergency complication of pregnancy: hemolysis, elevated liver enzyme levels, and low platelet levels.

HELLP syndrome is a life-threatening pregnancy complication that usually occurs in the third trimester and is often considered to be a variant of preeclampsia (high blood pressure and signs of liver or kidney damage during pregnancy). HELLP syndrome may also occur within 48 hours of delivery, but symptoms may take up to week to show.

HELLP describes the features of the condition: Hemolysis, Elevated Liver enzyme levels, and Low Platelet levels. 

What Are Symptoms of HELLP Syndrome?

Symptoms of HELLP syndrome include: 

• Tiredness
• Pain in the upper right or middle of the abdomen
• Severe headaches
• Nausea
• Vomiting
• High blood pressure (hypertension)
• Swelling, especially of the face and hands
• Excess weight gain
• Vision problems such as blurred vision
• Feeling unwell (malaise)
• Protein in urine
• Bleeding such as nosebleeds, bleeding from the gums, or other places (rare)
• Seizures (rare)

The cause of HELLP syndrome is not known.

Risk factors for developing HELLP syndrome include: 

• Preeclampsia or eclampsia
• Pregnancy induced hypertension 
• A previous pregnancy with HELLP syndrome 
• Being over age 25 
• Being Caucasian 
• Having given birth 2 or more times
• LCHAD deficiency in the fetus
• Certain genetic factors

HELLP syndrome is diagnosed with a physical examination and patient history. Because HELLP syndrome symptoms are similar to other pregnancy conditions and complications, tests should be run on any woman experiencing symptoms during the third trimester. Tests may include: 

• Blood tests
  • Red blood cells 
  • Liver function
• Blood pressure 
• Urine tests to check for protein 

The main treatment for HELLP Syndrome is the delivery of the baby. 

During pregnancy, treatments may include: 

• Blood product transfusion (red cells, platelets, plasma)
• Corticosteroids 

Complications of HELLP syndrome are more likely to occur in women with severe symptoms and severe laboratory abnormalities. Complications may include: 

• Disseminated intravascular coagulation (DIC)
• Placental abruption
• Acute kidney failure
• Pulmonary edema
• Premature birth (common)
  • This is the leading cause of fetal or newborn death 
• Increased risk of all forms of preeclampsia in subsequent pregnancies