HELLP SYNDROME

Dr Adrian Setiawan, SpOG

FK UKRIDA, Jakarta

What is HELLP Syndrome?

HELLP syndrome is a life-threatening

pregnancy complication usually
considered to be a variant of
preeclampsia. Both conditions usually
occur during the later stages of
pregnancy, or sometimes after
childbirth.

HELLP syndrome was named by Dr. Louis

Weinstein in 1982 after its characteristics:
H (hemolysis, abnormal peripheral blood
smear, increased bilirubin < 1.2 mg/dl,
increased lactic dehydrogenase > 600IU)
EL (elevated liver enzymes, increased
SGOT 72 IU/L, increased lactic
dehydrogenase > 600 IU/L)
LP (low platelet count < 100.000/mm)

HELLP syndrome can be difficult to diagnose,

especially when high blood pressure and
protein in the urine aren't present. Its
symptoms are sometimes mistaken for
gastritis, flu, acute hepatitis, gall bladder
disease, or other conditions.
The mortality rate of HELLP syndrome has been
reported to be as high as 25%. That's why it's
critical for expecting mothers to be aware of
the condition and its symptoms so they can
receive early diagnosis and treatment.

Symptoms of HELLP Syndrome

Headache
Nausea/vomiting/indigestion with pain after
eating
Abdominal or chest tenderness and upper
right upper side pain (from liver distention)
Shoulder pain or pain when breathing deeply
Bleeding
Changes in vision
Swelling

How HELLP Syndrome is Classified

The severity of HELLP syndrome is measured

according to the blood platelet count of the
mother and divided into three categories,
according to a system called "the Mississippi
classification. :
- Class I (severe thrombocytopenia): platelets
under 50,000/mm3
- Class II (moderate thrombocytopenia): platelets
between 50,000 and 100,000/mm3
- Class III ( mild thrombocytopenia): platelets
between 100,000 and 150,000/mm3

Treatment of HELLP
Syndrome

Most often, the definitive treatment for

women with HELLP Syndrome is the delivery
of their baby. During pregnancy, many
women suffering from HELLP syndrome
require a transfusion of some form of blood
product (red cells, platelets, plasma).
Corticosteroids can be used in early
pregnancy to help the baby's lungs mature.
Some healthcare providers may also use
certain steroids to improve the mother's
outcome, as well.

Maternal Complications with HELLP

syndrome

DIC
Pleural effusion
Acute Renal Failure
Eclampsia
Abruptio placentae
Pulmonary edema
Subcapsular liver hematoma
Intracerebral hemorrhage

Risk of Getting HELLP in Future Pregnancies

Women with a history of HELLP

syndrome are at increased risk of all
forms of preeclampsia in subsequent
pregnancies. The rate of preeclampsia in
subsequent pregnancies ranges from 16
to 52%, with higher rates if the onset of
HELLP syndrome was in the second
trimester. The rate of recurrent HELLP
syndrome ranges from 2 to 19%
depending upon the patient population
studied.

GOOD DAY !!!!!