What is HELLP?

Today Katrina is sharing my birth story on her blog, Mama's Organized Chaos. I'm so thankful for the opportunity to share our story and raise awareness about HELLP syndrome. So I thought I'd take the opportunity to share the sign and symptoms of HELLP Syndrome, for any readers who would like to know more about it. 

HELLP syndrome falls under the umbrella of Hypertensive Disorders of Pregnancy, this includes disorders such as preeclampsia, eclampsia, and gestational hypertension (chronic high blood during pregnancy). These complications are estimated to occur in 6-8% of pregnancies, with the prevalence being higher in 1st time moms. Preeclampsia is the most well-known of these complications, effecting 3-6% of pregnancies. Preeclampsia is characterized by high blood pressure and protein in the urine, usually striking after the 20th week of pregnancy. All though preeclampsia is very treatable if caught in time, untreated it can be fatal to mother and baby.

HELLP syndrome for a long time was thought to be a severe form of preeclampsia, but new research is showing that it can occur independently. Unfortunately this research is so new that most doctors aren't aware that it happens independent of preeclampsia, and can miss diagnosing HELLP if they don't see the signs of preeclampsia first. I was one of these misses-- I didn't have unusually high blood pressure, mine was still in the normal range (but it was elevated compared to my normal) and when first tested there wasn't protein in my urine.  

For me and many others, HELLP is first caught by noting certain markers on blood tests. Usually it's severely elevated liver enzymes (normal is about 30, mine were 600+), and severely low platelets (normal is 150-400 bil/L, mine was 35). These indicators weren't caught until 18 hours into my preterm labor. But had I known the signs of HELLP, it may likely have been caught sooner as I had many of them.

So what is exactly is HELLP? 

HELLP is a severe life-threatening pregnancy complication that is classified by these three signs: 

1. H: Hemolysis (red blood cells are being destroyed)
2. EL: Elevated liver proteins (liver is shutting down)
3. LP: Low platelets (losing the ability to form blood clots) 

HELLP can range in severity, but all told affects 0.5-0.9% of pregnancies. Most occurrences of HELLP happen between the 27th and 37th week of pregnancy, but it can occur before week 27 and up to 6 weeks post-delivery (often in women who had preeclampsia). The only known "cure" for HELLP syndrome is immediate delivery. Up to 25% of women die from HELLP or complications stemming from HELLP (such as liver or kidney failure/rupture, hemorrhage, or stroke). Up to 60% or infants die from complications of HELLP (such as very low birth-weight, or poor-functioning placenta).

The causes of HELLP and preeclampsia are poorly understood. More research is needed. Some current research points to problems with the placenta that occur as it forms in the early weeks of pregnancy. Research has however established that HELLP is a genetic disorder, but they have yet to pinpoint a specific gene or set of genes. This means that if a woman suffers from HELLP syndrome her female relatives (aunts, sisters, daughters, nieces, etc.) are also more likely to develop HELLP or a related Hypertensive Disorder of Pregnancy.

The risk factors for HELLP syndrome are believed to be:

• obesity/poor diet/lack of exercise
• maternal age of 25+
• previous pregnancies
• multiple pregnancy (twins or more)
• diabetes
• hypertension (high blood pressure)
• being Caucasian 
• having a hypertensive disorder of pregnancy in a previous pregnancy

Women who have had HELLP have a 19-25% of having it again in a subsequent pregnancy.

What are the symptoms of HELLP?

The symptoms of HELLP may include (* indicates symptoms I suffered prior to being diagnosed, some for weeks prior):

·       Severe headache*

·       Pain in the shoulder or neck or when breathing deeply*

·       Nausea/vomiting/indigestion*

·       Vision changes*

·       Upper right quadrant pain (pain in the right rib cage, often confused as heartburn)*

·       Swelling (especially hands and face)*

·       Seizures

·       Higher than normal blood pressure* (mine was in the normal range but was high for me, which highlights the importance of knowing your “normal” and speaking up)

·       Fatigue*

·       Bleeding (including nosebleeds)*

Unfortunately many of women who suffer from HELLP attribute their symptoms to normal pregnancy. But having a group of these symptoms should urge women to be seen by a doctor. And some of these symptoms warrant being checked even when presenting alone (such as seizure, upper right quadrant pain, vision changes, high blood pressure, and severe headache). 

I hope that this post has been informative, and can help save a life. Remember to trust you gut, if it bothers you get checked. And if you see these signs in a loved one, please encourage her to get checked. The embarrassment of a false alarm is much more tolerable than potentially losing your life or baby.

 

image source

**I am not a medical professional, this post is informational. It is not intended as to treat, diagnose, or provide medical advice. Please always consult a doctor if you have concerns about your health. **

Sources for this post include:

www.whatthehellp.com

http://www.preeclampsia.org/health-information/hellp-syndrome

http://www.healthline.com/health/hellp-syndrome#Overview1

https://www.nlm.nih.gov/medlineplus/ency/article/000890.htm