How to Manage Hellp Syndrome

HELLP, which stands for hemolysis, elevated liver enzymes, and low platelets, is a potentially fatal condition that affects approximately 10% of pregnant women with pre-eclampsia or eclampsia. A diagnosis of HELLP is typically given when a pregnant woman presents with elevated levels of certain liver enzymes, including AST, ALT, and LDH, and a subnormal platelet count. HELLP syndrome is an extremely serious pregnancy complication that can result in liver hemorrhage and rupture, anemia, DIC, renal failure, stroke, and pulmonary edema. In addition to the life-threatening risks to the mother, HELLP is also a significant threat to the baby, and can cause premature birth, placental separation, and respiratory distress. Treatment is crucial, and generally involves early delivery. When treatment is delayed, or if no treatment is given, up to 25% of women develop serious complications, and a smaller percentage die.

Instructions

How to Manage HELLP Syndrome

1. Seek medical help immediately if you experience any symptoms of pre-eclampsia, eclampsia, or HELLP syndrome. Symptoms of HELLP include fatigue, upper abdominal pain, nausea with or without vomiting, severe headache, visual disturbances, hypertension, edema, hyperreflexia, and possibly seizures.

2. Follow up with all necessary examinations and lab work. In addition to standard blood work, your doctor will likely order a blood pressure measurement, red blood cell count, liver function tests, platelet count, serum indirect bilirubin level, and urine test to check for the presence of protein. Be certain to verify if any of your tests require fasting before your blood is drawn.

3. Discuss treatment options with your obstetrician. Your treatment options will vary depending on a number of factors, including your overall health, how far along you are in your pregnancy, your medical history, the severity of your disorder, your ability to take necessary medications, and your personal preference. For severe cases of HELLP, or for pregnancies that are near term, delivery is typically the treatment of choice.

4. Adhere to any treatment regime given by your obstetrician, such as bed rest or daily fetal monitoring. Medications, including magnesium sulfate and antihypertensive drugs, may be administered either at home or in the hospital. Additionally, blood transfusions for anemia and low platelet counts may be required. Your baby will be closely monitored to check for signs of distress, and you will need to track fetal kicks and report any changes to your obstetrician. Nonstress tests, which measure the fetal heart rate in response to movement, and biophysical profiles will probably be scheduled several times each week until delivery. It is vital to your health, and to the health of your baby, to strictly follow any treatment instructions given to you by your doctor.

5. Prepare for early deliver of your baby. In nearly all cases, delivery will take place by cesarean section as soon as your baby’s lungs are mature. Corticosteroid medications may be given to speed up lung maturity, and you will receive advice and information about how to best prepare and care for a premature baby. If you show any signs of deterioration, or your baby appears to be in distress, your baby may be delivered before lung maturation occurs.