What Is HELLP Syndrome?

HELLP Syndrome vs. Preeclampsia

There may be a link between HELLP syndrome and preeclampsia and eclampsia. Preeclampsia is when a pregnant person has high blood pressure and damage to other organs such as their liver and kidneys. It usually starts after 20 weeks of pregnancy. Eclampsia is a more severe form of preeclampsia that includes seizures.

Some experts believe that HELLP syndrome is a severe type of preeclampsia, while others think HELLP might actually be a different disorder. Most people with HELLP have high blood pressure and protein in their urine, similar to preeclampsia. But about 15%-20% don’t have these symptoms. 

Either way, HELLP syndrome belongs to a group of conditions called hypertensive complications of pregnancy, along with preeclampsia, gestational hypertension, and eclampsia.

Causes of HELLP Syndrome

Doctors don’t know what causes HELLP syndrome. Your chance of it is higher if you’ve had it before. Most people who get it have high blood pressure first. But you can get HELLP with normal blood pressure.

Experts think your odds may be higher if you:

• Are older than 25
• Are white
• Have given birth two or more times before

HELLP Syndrome Symptoms

HELLP syndrome symptoms often come on quickly. They include:

• Fatigue
• Blurred vision
• Sudden weight gain
• Swelling, especially in your face and hands
• Headache
• Nausea or vomiting
• Seizures
• Pain in the upper right part of your belly
• Nosebleeds
• Bleeding that takes longer than usual to stop

HELLP Syndrome Diagnosis

If you have symptoms of HELLP syndrome, talk to your doctor. They’ll do a physical exam and tests to check for:

• High blood pressure
• Pain in the upper right side of your belly
• Enlarged liver
• Swollen legs
• Liver function
• Blood platelet count
• Bleeding into your liver

HELLP Syndrome Treatment

The main solution for HELLP syndrome is to give birth as soon as possible. This means your baby may have to be born early. The risks are too serious for you and your baby if you stay pregnant with HELLP syndrome.

Treatment may also include:

• Corticosteroid medicines to help your baby’s lungs develop more quickly
• Medicines for high blood pressure
• Meds to prevent seizures
• Blood transfusion

Prevention

There’s no way to prevent HELLP syndrome. The best thing you can do is keep yourself healthy before and during pregnancy and watch for early signs of the condition. The following steps can help:

• See your doctor regularly for prenatal visits.
• Tell your doctor if you’ve had any high-risk pregnancies or if someone in your family has had HELLP syndrome, preeclampsia, or other blood pressure problems.
• Know the symptoms and call your doctor ASAP if you have them.

HELLP Syndrome and Anesthesia

When you have HELLP syndrome, giving you anesthesia for your C-section can be a difficult decision for your doctor to make because symptoms such as low platelet count, bleeding, and high blood pressure could cause you more health problems. Doctors also don’t have clear guidelines on what anesthesia to use or the best way to manage this situation.

A case report of a 35-year-old, 25-week pregnant person with HELLP syndrome found that using spinal anesthesia (where the drug is injected into the lower back that you may be awake with) comes with a lower risk of bleeding in the brain compared with general anesthesia (which make you completely asleep).

Another case report involving a 28-year-old, 34-week pregnant person with HELLP and other health problems suggests that spinal anesthesia can be considered if you have HELLP, normal blood clotting, and a corrected platelet count.

Your doctor will weigh the risks and benefits of different anesthetic methods and determine which is best for your case.

Life After HELLP Syndrome

HELLP syndrome gets better after delivery. But your doctor still has to keep monitoring you because you might have bleeding and need to get emergency blood transfusions.

Although this condition is relatively rare, if you’ve had HELLP, you’ll likely have it again in your next pregnancy. You might also have high blood pressure and heart diseases later in life.

Having HELLP syndrome is a sudden and overwhelming change to your pregnancy reality. Getting medical help and receiving urgent treatment may also cause mental and emotional distress. The overwhelming feelings may continue even after you’ve gotten treatment for your symptoms and you and your baby are safe and fine.

Having a strong support system that includes your loved ones, your doctor, and other people who have had HELLP syndrome or other serious pregnancy complications can help with your mental and emotional recovery. 

• Ask your loved ones for help with daily errands and chores as needed so you can take more time to recover. 
• Follow your doctor’s recommendations for treatment, rest, and recovery. If you have any questions or concerns about your medicines, contact them as soon as you can.
• Consider joining online or in-person support groups to connect with and learn from other families who have had similar experiences. This can help with any feelings of loneliness or isolation you may be experiencing. You can find support groups and places to share your story, as well as learn from others, on the Preeclampsia Foundation, Momma's Voices, and Preeclampsia, Eclampsia & HELLP Syndrome Survivors Global Support Network.
• Be gentle with yourself. You might feel grief, guilt, and other emotions that are hard to understand or explain. This is normal, and showing kindness can make your mental and emotional recovery smoother. Journaling or getting involved in a creative hobby can help with self-expression and releasing unpleasant emotions.
• Speak with a therapist. Consider working with a therapist who specializes in pregnancy complications and postpartum care. They can help you process your feelings and manage your emotions.

Takeaways

HELLP syndrome is a rare pregnancy complication that often happens during the third trimester. But it can also occur during labor and delivery or after delivery. No one knows how to prevent it yet, but get immediate medical help if you have symptoms such as extreme tiredness, blurred vision, weight gain, headache, nausea, and vomiting. This condition can be treated and goes away after delivery for most people. It can happen to you again in another pregnancy, so talk to your doctor about the best ways to reduce your chances of having it again.

HELLP Syndrome FAQs

What are the criteria for HELLP?

The criteria for HELLP include: 

• Hemolysis or breakdown of red blood cells
• Elevated liver enzymes
• Low platelet count

What is the difference between DIC and HELLP syndrome?

Disseminated intravascular coagulation (DIC) is a rare blood clotting disorder that often happens as a complication of other serious health problems such as HELLP syndrome. It causes organ damage and bleeding, complicating emergency surgeries in people with HELLP syndrome.

DIC symptoms include uncontrollable bleeding from different body parts, bruising, fever, difficulty breathing, confusion, and memory loss. HELLP syndrome also involves prolonged bleeding but is marked by additional symptoms such as fatigue, sudden weight gain, and swelling.

Does HELLP syndrome go away?

Yes, HELLP syndrome often goes away within three days after giving birth.