HELLP Syndrome

Question 1

What is HELLP syndrome?

Answer 1

• Haemolysis (red blood cell rupture demonstrated on blood film and leading to a drop in haemoglobin level)
• Elevated liver enzymes (raised ALT - alanine transaminase)
• Low Platelets (cell fragments involved in the clotting process)
• it is a multi-system disorder characterised by activation of the coagulation system leading to increased deposition of the protein fibrin throughout the body
• this causes damage to red blood cell membranes leading to fragmentation of cells
• in the liver, fibrin deposited within the organs blood vessels deceases the vessel diameter and therefore lowers the blood volume reaching liver cells and increases the pressure of blood flow leading to injury or death of liver cells
• fibrin deposits on the walls of any blood vessel damage leading to activation and clumping together of platelets which forms blood clots and lowers the platelet count

Question 2

What are some of the signs and symptoms of HELLP?

Answer 2

• women often present with signs and symptoms of severe pre-eclampsia
• in particular may have - abdominal pain, liver tenderness, nausea and vomiting

Question 3

What are the complications associated with HELLP?

Answer 3

• DIC
• placental abruption
• acute renal failure
• pulmonary oedema
• liver haematoma and rupture