Chapter 11: HELLP Syndrome

Question 1

What does HELLP Syndrome Mean?

Answer 1

Hemolysis
Elevated Liver enzymes
Low Platelet levels
>as a result of the arteriolar vasospasms in the cardiovascular system that occur in preeclampsia, the circulating red blood cells (RBCs) are destroyed as they try to navigate through the constricted vessels (Hemolysis)
>Vasospasms decrease blood flow to the liver, resulting in tissue ischemia and hemorrhagic necrosis (Elevated Liver enzyme level)
>In response to the endothelial damage caused by the vasospasms (small openings develop in the vessels), platelets aggregate at the site and a fibrin network is set up, leading to a decrease in the circulating platelets (Low Platelet level)

Question 2

What is HELLP Syndrome

Answer 2

rare, serious complication of preeclampsia that can manifest at any time during pregnancy and the puerperium, but rare before 20 weeks gestation
-occurs more often in Caucasians, multiparas, and in women older than 35

Question 3

How is HELLP Syndrome Characterized?

Answer 3

a laboratory diagnosis for a variant of preeclampsia with severe features
-primary presentation is consistent with hepatic (liver) dysfunction evidenced by liver function tests
>characterized by rapidly deteriorating liver function and thrombocytopenia
>liver capsule distension often produces epigastric pain
>other maternal signs: malaise with flu-like complaints, nausea or vomiting, headache, shoulder pain, and bruising or hematuria

Question 4

Therapy for HELLP Syndrome

Answer 4

centers on improving platelet count by transfusion of fresh-frozen plasma or platelets and delivery as soon as feasible by vaginal or cesarean birth

Question 5

Nursing Care

Answer 5

• continuous maternal-fetal monitoring
• measurement of central venous pressure or pulmonary arterial wedge pressure (Swan-Ganz catheter) may be required to monitor fluid status when pulmonary edema or acute renal failure is present