HELLP syndrome
A pregnancy complication with hemolysis, elevated liver enzymes, and low platelets.
The acronym HELLP stands for hemolysis, elevated liver enzymes, and low platelet count, and it describes a complication that can arise during pregnancy.[1]
Quick Facts
- Field
- Obstetrics
- Symptoms
- Feeling tired
- retaining fluid
- headache
- nausea
- upper abdominal pain
- blurry vision
- seizures
- Complications
- Disseminated intravascular coagulation (DIC)
- placental abruption
- kidney failure
- pulmonary edema
- Onset
- Last 3 months of pregnancy or shortly after childbirth
- Types
- Complete, incomplete
- Risks
- Preeclampsia
- eclampsia
- previously having HELLP
- mother older than 25 years
- Diagnosis
- Blood tests
- Differential
- Viral hepatitis
- thrombotic thrombocytopenic purpura
- cholangitis
- hemolytic uremic syndrome
Facts from the source article.
Key facts and history
Dr. Louis Weinstein identified HELLP syndrome as a distinct clinical entity in 1982.[2] In a 2005 article, Weinstein wrote that the unexplained postpartum death of a woman motivated him to review the medical literature.[2] Class I, the most severe, has a platelet count below 50,000/μL.[3] With treatment, maternal mortality is about 1 percent.[4]
The etiology of HELLP syndrome remains unidentified.[5] In a 2005 article, Weinstein remarked that instances displaying HELLP characteristics had been documented as far back as 1954.[2] Blood test results are the basis for diagnosis: they must show red blood cell breakdown (indicated by lactate dehydrogenase above 600 U/L), aspartate transaminase exceeding 70 U/L, and a platelet count under 100×10⁹/L.[5] The Mississippi classification system gauges syndrome severity by the patient's lowest recorded platelet count.[3]
The standard approach to management is to deliver the infant at the earliest opportunity.[6] For every 1000 babies born to mothers with HELLP syndrome, the perinatal death rate ranges from 73 to 119.[4]
What the research sources say
The Genetic and Rare Diseases Information Center (GARD) lists HELLP syndrome under categories including blood diseases and urinary and reproductive diseases.[7] The GARD entry notes that symptoms may include abdominal pain, acute kidney injury, and placental abruption.[7] The Merck Manual states that HELLP syndrome develops in less than 1% of pregnancies and that most affected women have high blood pressure and protein in the urine, but some have neither.[8] The Merck Manual also reports that delivery is usually done as soon as possible when HELLP syndrome is present.[8]
References
- Wikipedia, "HELLP syndrome" (CC BY-SA 4.0), which cites: "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018; "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018; "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018; "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018 (we also read that source) en.wikipedia.org
- Wikipedia, "HELLP syndrome" (CC BY-SA 4.0), which cites: "Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy", Am J Obstet Gynecol, January 1982, p. 159–67; "It has been a great ride: The history of HELLP syndrome", Am J Obstet Gynecol, September 2005, p. 860–3; "It has been a great ride: The history of HELLP syndrome", Am J Obstet Gynecol, September 2005, p. 860–3; "Intravascular hemolysis, thrombocytopenia and other hematologic abnormalities associated with severe toxemia of pregnancy", N Engl J Med, Jan 1954, p. 89–98 (or en.wikipedia.org
- Wikipedia, "HELLP syndrome" (CC BY-SA 4.0), which cites: "Pregnancy complicated by preeclampsia-eclampsia with the syndrome of hemolysis, elevated liver enzymes, and low platelet count: how rapid is postpartum recovery?", Obstet Gynecol, November 1990, p. 737–41 (original not read by us) en.wikipedia.org
- Wikipedia, "HELLP syndrome" (CC BY-SA 4.0), which cites: Belfort, "Hypertension in Pregnancy", CRC Press, 2002, p. 159–60; Stevenson, "Fetal and Neonatal Brain Injury", Cambridge University Press, 2003, p. 260 (we also read that source) en.wikipedia.org
- Wikipedia, "HELLP syndrome" (CC BY-SA 4.0), which cites: "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018; "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018; "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018; Cohen, "Disorders of Thrombosis and Hemostasis in Pregnancy: A Guide to Management", Springer, 2015, p. 305; "The HELLP syndrome: clinical issues and management. A Review", BMC Pregnancy Childbirth, February 2009, p. 8; "The HELLP syndrome: clinical issue en.wikipedia.org
- Wikipedia, "HELLP syndrome" (CC BY-SA 4.0), which cites: "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018; "The HELLP syndrome: clinical issues and management. A Review", BMC Pregnancy Childbirth, February 2009, p. 8; "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018 (we also read that source) en.wikipedia.org
- "HELLP syndrome", Genetic and Rare Diseases Information Center (GARD) – an NCATS Program, 2018. facts only, no text reused. rarediseases.info.nih.gov
- "Preeclampsia and Eclampsia", Merck Manuals Consumer Version, March 2018. facts only, no text reused. merckmanuals.com
Each numbered sentence above was checked against the source it cites before publication. Sentences citing Wikipedia adapt text from the English Wikipedia article HELLP syndrome (contributors), used under CC BY-SA 4.0; this entry is available under the same licence. Other sources were used for facts only; no text or images are copied from them.
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