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http://members.aol.com/HELLP1995/hellpmedicalfacts.html

Medical Facts About HELLP Syndrome

A History of HELLP Syndrome

HELLP syndrome, which is a unique variant of preeclampsia (toxemia),

was named by Louis Weinstein in 1982 after its characteristics:

H (hemolysis, which is the breaking down of red blood cells),

EL (elevated liver enzymes), and

LP (low platelet count).

It can be fatal to both the mother and the baby.

HELLP Syndrome occurs in tandem with preeclampsia, but because HELLP

Syndrome's symptoms may happen before preeclampsia's three findings

(high blood pressure, protein in the urine, and swelling), they may

be misdiagnosed as symptoms of gastritis, disseminated intravascular

coagulation (DIC), acute hepatitis, gall bladder disease, and other

conditions. As a result, the mother may not get the right treatment,

leaving both mother and baby that much more at risk.

Who is at Risk of Getting HELLP Syndrome?

Five to seven percent of all pregnant women in the United States

develop preeclampsia. Between two and 12 percent go on to suffer

from HELLP Syndrome. Best estimates are that HELLP Syndrome occurs in

one per 150 live births (about one half of one percent), with a

maternal mortality rate of 3.50 percent.

Just how often does HELLP Syndrome happen? The exact number is

unknown, because doctors may or may not catch it. Athough it can

happen to any pregnant woman, doctors believe it happens most to

older, white women who have had more than one child. If the diagnosis

of preeclampsia was delayed or it was managed too conservatively, a

woman's likelihood of developing HELLP Syndrome is even higher.

Symptoms of HELLP Syndrome

The physical symptoms of HELLP Syndrome may seem at first like other

pregnancy-induced high blood pressure conditions (such as

preeclampsia).

Signs for a pregnant woman to look for include one or all of the

following:

headache

nausea/vomiting

epigastric (stomach) tenderness and right upper quadrant pain (from

liver distention)

These symptoms may or may not be present:

severe headache

visual disturbances

bleeding

swelling

high blood pressure

protein in the urine

The most common reason for the mother to die is from her liver

rupturing. This can often be prevented if it's caught in time! If

you or someone you know has any of these symptoms, please see a

doctor immediately!

The only definitive treatment for women with HELLP Syndrome is

delivery, regardless of how far along in the pregnancy the woman is.

What does this mean for the babies?

Babies Born from HELLP Syndrome

The good news is, in the majority of cases, the babies born to

mothers with HELLP Syndrome do remarkably well. In a recent survey of

babies born to mothers with HELLP Syndrome at WVU Children's

Hospital, the most important thing is the size of the baby.

If the baby weighs over 1000 grams (approx. 2 lbs.), at birth, his or

her survival rate and length of hospital stay is similar to non-HELLP

babies of comparable sizes, and there doesn't seem to be many long-

term adverse outcome. West Virginia University is studying long-term

medical and developmental outcome of these babies.

If the baby weighs than 1000 grams at delivery, the news is not so

good. Several studies have suggested longer hospital stays and more

chance of needing ventilator care. Data from WVU Children's Hospital

suggests that these small babies have a decreased chance of survival

compared to other babies of the same size. Unfortunately, right now

doctors can't predict the scope of the medical problems that these

small babies encounter. Research into the effects of HELLP Syndrome

on the newborn is ongoing at WVU and elsewhere.

How likely is the baby to die from HELLP Syndrome? Dr. Baha Sibai

M.D., a perinatologist from the University of Tennessee in Memphis,

notes that the perinatal mortality from HELLP Syndrome, " ranges from

7.7 to 60 percent. " Most of these deaths are attributed to abruption

of the placenta (placenta prematurely separating), intrauterine

asphyxia (fetus not getting enough oxygen), and extreme prematurity.

Risks of Getting HELLP in Future Pregnancies

Studies vary on their estimates of HELLP occuring again. One study

(Sibai, et al, 1995) places the risk at 5%. Another one (Sullivan, et

al, 1994) finds it to be between 19% and 27%.

Both studies agree that HELLP mothers have increased risk (40-50%)

for pregnancy-related complications in general with any future

pregnancies. Some of these complications might include (but aren't

limited to) gestational diabetes, high maternal blood pressure (that

doesn't lead to HELLP Syndrome), and premature birth of the baby.

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