HELLP syndrome

HELLP syndrome
Classification and external resources
Specialty	Obstetrics
ICD-10	O14.2
ICD-9-CM	642.5
DiseasesDB	30805
MedlinePlus	000890
eMedicine	ped/1885
Patient UK	HELLP syndrome
MeSH	D017359
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HELLP syndrome is a life-threatening pregnancy complication usually considered to be a variant or complication of pre-eclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth. "HELLP" is an abbreviation of the three main features of the syndrome:Hemolysis, Elevated Liver enzymes, and Low Platelet count. The syndrome may be associated with serious liver manifestations, including infarction, hemorrhage, and rupture.

HELLP usually begins during the third trimester; rare cases have been reported as early as 21 weeks gestation. Often, a woman who develops HELLP syndrome has already been followed up for pregnancy-induced hypertension (gestational hypertension), or is suspected to develop pre-eclampsia (high blood pressure and proteinuria). Up to 8% of all cases occur after delivery.

Women with HELLP syndrome often "do not look very sick." Early symptoms can include:

Gradual but marked onset of headaches (30%), blurred vision, and paresthesia (tingling in the extremities) can occur. Edema may occur, but its absence does not exclude HELLP syndrome. Arterial hypertension is a diagnostic requirement, but may be mild. Rupture of the liver capsule and a resultant hematoma may occur. If a woman has a seizure or coma, the condition has progressed into full-blown eclampsia.

Disseminated intravascular coagulation is also seen in about 20% of all women with HELLP syndrome, and in 84% when HELLP is complicated by acute renal failure.Pulmonary edema is found in 6% of all women with HELLP syndrome, and when HELLP is complicated by acute renal failure, pulmonary edema is found in 44% of women with the syndrome.

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