HELLP syndrome in pregnancy
Posted on 7 February 2017
We asked a Mediclinic specialist about HELLP syndrome – a rare but life-threatening complication of pre-eclampsia.
HELLP stands for haemolysis (breakdown of red blood cells), elevated liver enzymes and low platelets, explains Dr Elizabeth De Gouveia, a gynaecologist & obstetrician at Mediclinic Gynaecological Hospital in Sunnyside, adding that in her 10 years of private practice she has only managed about five cases of HELLP syndrome.
As is the case with pre-eclampsia, HELLP syndrome can be asymptotic, meaning it is present without symptoms, but it can also present with symptoms such as headaches, nausea, indigestion, pain in the upper abdomen or shoulder, and visual disturbances.
HELLP syndrome is seen in about 15% of cases of severe pre-eclampsia and puts the infant at higher risk of being born at a lower weight than normal or developing neurological disabilities after the birth.
Read more about pre-eclampsia here: https://www.mediclinicinfohub.co.za/pre-eclampsia-in-pregnancy/
The only definitive treatment for HELLP syndrome is to deliver the baby as soon as possible after diagnosis. If there is enough time, corticosteroids will be administered to improve the baby’s lung maturation. Some studies show that corticosteroids may also prevent certain maternal complications.
Fortunately, if the baby is delivered as soon as possible, maternal mortality is low at around 1% of cases. However, 1 in 4 women develop complications that range from kidney and liver failure to the retina detaching from the rest of the eye.
What causes pre-eclampsia?
Various theories exist, but none have been proven so far. Dr De Gouveia says one theory points to a disturbed placental function in early pregnancy, while another suggests the mother’s body has a reaction to the foreign half of the baby – the 50% of the genetic material belonging to the father.
Once women have experienced HELLP syndrome, they have a 2 in 3 chance of developing pre-eclampsia in future pregnancies, which may bring with it a recurrence of HELLP syndrome. Specialists may recommends regular check-ups during subsequent pregnancies and thereafter, as HELLP syndrome can be a predictor of hypertension and diabetes in future.
Additional reading: http://perinatal.co.za/patients/medical-conditions/hellp-syndrome/