As with all complications that occur during pregnancy, a diagnosis of HELLP syndrome can be frightening to a new mother and her family. Educating patients about this disease can help reduce that fear and allow for calm, rational decisions to be made regarding treatment.
What is HELLP Syndrome?
Usually understood to be a variant of preeclampsia, HELLP syndrome is named for an abbreviation of the main symptomatic conditions used to diagnose the condition: hemolytic anemia, elevated liver enzymes, and a low platelet count. This condition, like preeclampsia and eclampsia, generally occurs during the later stages of pregnancy, but can sometimes surface even after childbirth. The exact cause of the disease is unknown, and there is no known way to prevent it from occurring; however, certain risk factors may allow doctors to assess risk levels during pregnancy.
Preeclampsia and Eclampsia
Preeclampsia is a hypertensive condition that arises in pregnant women mainly during the third trimester. The diagnosis refers to a set of symptoms rather than a specific cause. It seems to occur when substances from the placenta cause a dysfunction of the endothelial or inner walls of the blood vessels in a susceptible pregnant woman, leading to damage of the kidneys, liver, and blood vessels. Early onset preeclampsia occurs before 32 weeks, and is generally associated with increased rates of fatality. Eclampsia, an acute progression of preeclampsia, involves seizures and coma.
How is a Diagnosis Made?
Preeclampsia is diagnosed based on blood pressure and uric protein levels in a pregnant woman. Two separate blood pressure readings must be taken at least 6 hours apart. It was once thought that edema, or swelling of the hands and face, was an important symptom for diagnosis, but this has since been discarded and now only hypertension and proteinuria are important. Blood tests may be performed to determine blood count, liver enzymes, renal function, and electrolyte levels in patients suspected to have HELLP syndrome; this is a very specific form of preeclampsia, and may present with different symptoms.
HELLP syndrome is known to occur primarily in Caucasian women over the age of 25, but women under the age of 20 or those pregnant for the first time are also at risk. Women who have experienced eclampsia or preeclampsia during a previous pregnancy should be monitored closely, as they are likely to develop symptoms a second time. Ultimately, any woman is a potential candidate for the condition, and those who experience symptoms should consult a doctor as quickly as possible.
This type of preeclampsia is relatively rare, and only 0.2% to 0.6% of all pregnant women in North America will be affected. The majority of those who do suffer from HELLP syndrome will recover without difficulty, and babies born to mothers with preeclampsia are generally healthy after the birth. When this is not the case, infant health issues are generally related to premature delivery and not to the motherís condition. Unfortunately there is a morbidity rate of 2% for mothers and about 8% for infants; these deaths are usually the result of complications surrounding the pregnancy.
All women should be vigilant during pregnancy so that signs of preeclampsia can be reported before they become serious. However, it is not a common condition, and there is no need for undue concern. With proper management and delivery of the baby, preeclampsia need not prevent a mother or her baby from living full, happy lives after birth.