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HELLP syndrome Health Article

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Definition

HELLP syndrome is a group of symptoms that occur in pregnant women who have:

Causes, incidence, and risk factors

HELLP syndrome occurs in approximately 10% of pregnant women with preeclampsia or eclampsia. HELLP syndrome is associated with more serious cases.

Many women have high blood pressure and are diagnosed with preeclampsia before they develop HELLP syndrome. However, in some cases, HELLP symptoms are the first warning of preeclampsia and the condition is misdiagnosed as hepatitis, gallbladder disease, idiopathic thrombocytopenic purpura, or thrombotic thrombocytopenic purpura.

Symptoms

  • Headache
  • Nausea and vomiting that continues to get worse
  • Upper abdominal pain
  • Vision problems

Signs and tests

During a physical examination, the doctor may discover upper abdominal tenderness, especially in the right upper side. The liver may be enlarged.

Liver function tests (liver enzymes) may be elevated. Red blood cell and platelet counts may be low.

Treatment

The main treatment is to deliver the baby as soon as possible, even if premature, since liver function in the mother gets worse very quickly. Problems with the liver can be harmful to both mother and child.

Expectations (prognosis)

When the disease is not treated early, up to 25% of women develop serious complications. Without treatment, a small number of women die. The death rate among babies born to mothers with HELLP syndrome varies and depends on birth weight and the development of the baby's organs, especially the lungs. (See also: Prematurity)

Complications

The mother's liver may bleed (hemorrhage). Permanent liver damage may occur if delivery is delayed. Such damage can lead to death.

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Reviewer Info: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington ; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.; ADAM Health Illustrated Encyclopedia, 10/28/2008
 
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