What is the HELLP syndrome?

HELLP syndrome is the medical name given to a serious complication of Pre Eclampsia involving a combination of liver and blood disorders. HELLP stands for H (haemolysis - red blood cell damage); EL (elevated liver enzymes - indicating liver damage); and LP (low platelets in the blood leading to a bleeding tendency). HELLP syndrome may be associated with other signs of Pre Eclampsia, such as high blood pressure, protein in the urine and swelling of the hands, feet or face. However, this is not always the case, and this may make its diagnosis more difficult. Women with HELLP syndrome often complain of a pain in the upper abdomen below the ribs, which is indicative of a tender liver. There may also be heartburn, vomiting and headache. The upper abdominal pain of the HELLP syndrome can be very severe, and is not relieved by simple remedies such as antacids, which would be the case if heartburn, for example, was the cause of the pain. HELLP syndrome symptoms can often be confused with other problems such as gallstones (cholelithiasis), inflammation of the gall bladder (cholecystitis) or liver inflammation (hepatitis).

As with the more typical cases of Pre Eclampsia, HELLP syndrome can arise at any stage during the second half of pregnancy.

The diagnosis of HELLP syndrome can be made by blood tests which examine liver enzymes, red blood cells and platelets. As with typical Pre Eclampsia, delivery is required for cure of the HELLP syndrome,irrespective of the stage of the pregnancy and maturity of the baby. Because the HELLP syndrome can be associated with a bleeding tendency secondary to a deficiency of platelets, it may be necessary to administer platelet transfusions. This may be particularly important before undertaking any surgery, such as a Caesarean section.

Medical information supplied by:
Professor Shaun Brennecke
Director of Perinatal Medicine and University of Melbourne Department Head of Obstetrics and Gynaecology at the Royal Women's Hospital, Melbourne