Curriculum · Gynecology / Women's Health / Infertility / Perinatal Care / Birth Spacing
HELLP syndrome
What it is
HELLP stands for hemolysis, elevated liver enzymes and low platelet count. It is listed among the severe features of preeclampsia, on the hematologic line with thrombocytopenia under 100 and microangiopathic hemolytic anemia, and it is also listed among the maternal complications that preeclampsia runs into.
Causes and risk
The risk factors are those of preeclampsia: nulliparity, multiple gestation, hydatidiform mole, chronic HTN, DM, renal disease, autoimmune disease, a family history, black race, obesity, and extremes of maternal age.
How it presents
The features that mark severe disease and press for urgent delivery are severe HTN at or above 160/110 on 2 occasions, a persistent or severe headache, visual abnormalities, upper abdominal or epigastric pain, nausea and vomiting, dyspnea or retrosternal chest pain, and altered mental status. The hepatic line of severe preeclampsia is epigastric or RUQ pain with raised LFTs, and the CNS line is headache, diplopia and seizures.