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HELLP Syndrome

What Is HELLP Syndrome?

HELLP syndrome is a life threatening pregnancy complication usually considered to be a variant of preeclampsia. These conditions usually occur during the later stages of your trimester or sometime after childbirth.

HELLP Syndrome Stands For?

H- Hemolysis lack of break down of red blood cells

EL- Elevated liver enzymes

LP- Low platelet count

HELLP Syndrome Classification

Depending on the patient’s blood platelet count the syndrome is classified into three categories:

Class I:  Characterized by severe thrombocytopenia. Platelet count under 50,000/mm3

Class II: Characterized by moderate thrombocytopenia. Platelet count between 50,000/mm3 and 100,000/mm3

Class III:  Characterized by mild thrombocytopenia. Platelet count between 100,000/mm3 and 150,000/mm3

What Causes HELLP Syndrome
In Pregnancy?

The main causes of HELLP Syndrome are:

  • History of suffering from preeclampsia from previous pregnancy
  • Women over the age of 25
  • Suffering from obesity
  • Suffering from diabetes
  • Inadequate exercise
  • Being Caucasian
  • Carrying twins
  • Unhealthy diet
  • Lack of exercise

HELLP Syndrome Pathophysiology

The pathophysiology of HELLP syndrome is ill defined. Some theorize that, because HELLP is a variant of preeclampsia, the pathophysiology stems from a common source.

What Are The Symptoms of HELLP Syndrome?

The most common symptoms of HELLP syndrome include:

  • Fatigue
  • Abdominal pain
  • Nausea
  • Vomiting
  • Headaches
  • Indigestion
  • Shoulder and neck pain
  • Chest and abdominal tenderness
  • Vision problems
  • Edema
  • Seizure
  • Pain in the liver
  • High blood pressure
  • Bleeding
  • Protein in urine
  • Feeling generally unwell
  • Excessive weight gain

How To Prevent HELLP Syndrome?

The best ways to prevent HELLP syndrome include:

  • Bed rest
  • Corticosteroid
  • Blood transfusion
  • Blood pressure medication
  • Fetal monitoring and test

HELLP Syndrome Diagnosis And Diagnostic Criteria

The HELLP has similar symptoms such as the flu.  The proper medical diagnosis will be needed to blood tests that help determine platelet levels.  It counts your red blood cell count to check for hemolysis. 

Additional testing will include an urine test to detect any high liver enzyme. Lastly, your doctor might recommend doing a CT scan to help determine any bleeding in your liver.

HELLP Syndrome Differential Diagnosis

  • Acute fatty liver in pregnancy
  • Gall bladder diseases
  • Gastritis
  • Thrombotic thrombocytopenic purpura
  • Haemolytic uraemic syndrome

How To Treat HELLP Syndrome?

Majority of women experience HELLP syndrome within 34 weeks of gestation. The most common treatments to manage the condition are the following:

  • Full bed rest
  • Monitoring the fetal development
  • Blood transfusion if platelet counts gets too low
  • Magnesium Sulfate help prevents seizure
  • Corticosteroid to help babies lung develop more rapidly

HELLP Syndrome Complications

  • Acute renal failure
  • Placental abruption
  • Ruptured liver hematoma
  • Stillbirth
  • Death of the mother
  • Pulmonary edema
  • Stroke
  • Kidney damage
  • Intrauterine growth restriction
  • Permanent liver damage
  • Lung failure in the mother or baby

HELLP Syndrome Recurrence

If the pregnant women have had a history of preeclampsia is between 2% and 19%.

HELLP Syndrome ICD-10 Code

The ICD-10 Code for HELLP syndrome is O14.2

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