Health & Fitness, Pregnancy, Women Guide

Hellp Syndrome Treatment Guidelines

A HELLP syndrome often develops within a few hours – HELLP syndrome is one of the most serious pregnancy-related illnesses and only becomes apparent in the last trimester of pregnancy.

What is the HELLP syndrome?

The term “HELLP syndrome” was coined by the British doctor. Louis Weinstein in 1982, he reflects the main laboratory symptoms of the disease:

  • H – hemolysis – bluer case
  • EL – Elevated Liver Enzyme – Elevated Liver Values
  • LP – Low Platelet Count – Declining blood clotting

The number of blood platelets (platelets) responsible for the blood coagulation falls to values below 100,000 per microliter of blood.

Also, the function of the kidneys is very often disturbed, partly there is protein in the urine of the affected women. At the same time, the disease is one of the so-called hypertensive disorders in pregnancy, causing a rapid increase in blood pressure.

High blood pressure and protein in the urine (proteinuria) are also the typical symptoms of pre-eclampsia – in women with HELLP syndrome, however, they do not occur in all cases. Although 5 to 15 percent of those affected show the typical laboratory values of the disease, they do not develop proteinuria.

Which warning do signs make a HELLP syndrome noticeable?

A HELLP syndrome often develops within a few hours. Characteristic warning signs are severe pain in the right upper abdomen and swelling/water retention on the extremities and face. Also, visual disturbances, a yellowing of the skin, sudden nausea, diarrhea, and vomiting, or severe itching on the skin can indicate that the pregnant woman develops a HELLP syndrome.

However, the chief symptoms considered are an upper abdominal pain. Some women also experience pain in the kidney area or the entire back. The final diagnosis is made in the laboratory by specific blood and liver values as well as the number of platelets.

Many of these symptoms may be manifested during pregnancy for other and much more benign reasons. On the other hand, as well as high blood pressure and protein in the urine, they may be completely absent in women who are affected by HELLP syndrome, or they may initially be more unspecific.

It is important that a blood test as soon as possible clarifies the occurrence of appropriate symptoms and especially the widening of the symptoms.

How is HELLP syndrome treated?

A fully developed HELLP syndrome is a medical emergency in which action is needed quickly. The mother usually requires intensive care treatment; cesarean section brings the baby. Among other things, antihypertensive and anti-spasmodic drugs are used for medical treatment.

Causal drug therapy is not yet known, is currently being investigated in this context, the effectiveness of glucocorticoids – a particular class of adrenal hormones, which are used for example in acute shock states, as anticonvulsants and for the treatment of autoimmune reactions.

In a partial HELLP syndrome – if not all relevant laboratory values are pathologically altered – very slow disease or a very immature baby can be tried to prevent the progression of the disease by therapeutic plasmapheresis, in which the patient’s blood plasma by a substitution solution as well as fresh plasma is replaced.

However, conservative treatment of HELLP syndrome has so far been a special case due to the unforeseeable dynamics.

How common is HELLP syndrome and how does it affect the baby?

Statistically, the HELLP syndrome occurs in 0.2 to 0.85 percent of all pregnancies. However, a HELLP syndrome can be very dangerous for the baby. The mortality of the children whose mothers develop a HELLP syndrome lies between 10 and 40 percent, again based on various studies.

The statistical recurrence risk in later pregnancy is between 3 and 5 percent.

Are there preventive measures?

Effective prevention of HELLP syndrome does not yet exist. In addition to high blood pressure and kidney problems, risk factors include immune disorders and autoimmune diseases, previously experienced hepatitis and the tendency of the mother to thrombosis.

In such cases, pregnancy is very likely to be classified as a high-risk pregnancy right from the outset and closely monitored.

CONCLUSION

  • The HELLP syndrome is one of the most serious pregnancy illnesses ever. It can be life-threatening for both the mother and the baby.
  • In a HELLP syndrome, the blood clotting and liver function are massively disturbed, which can lead to numerous serious complications.
  • The treatment usually consists of the fastest possible cesarean section and the subsequent intensive medical treatment of the mother. Conservative therapy is only undertaken in exceptional cases.
  • The HELLP syndrome statistically occurs in 0.2 to 0.85 percent of all pregnancies, making it a rare disease.

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