HELLP syndrome is a series of events that can threaten pregnancy. HELLP stands for three conditions, namely:
- H (hemolysis), namely the damage or destruction of red blood cells, which have the task of transporting oxygen from the lungs to the rest of the body.
- EL (elevatedliver enzymes), or increased levels of enzymes produced by the liver, due to impaired liver function.
- LP (low platelet count), or low levels of platelets (platelets). Platelets play a role in the blood clotting process.
Symptoms of HELLP syndrome include headache, nausea, vomiting, weakness, feeling unwell, swelling of the face or arms, weight gain, pain in the upper right abdomen, bleeding, and seizures.
HELLP syndrome occurs in 1-2 out of 1000 pregnancies. In pregnant women who have high blood pressure (preeclampsia) or seizures (eclampsia), the risk of developing HELLP syndrome increases to 10-20 percent. This syndrome usually occurs in the 3rd trimester of pregnancy or at 26-40 weeks of gestation. But in some cases, HELLP syndrome occurs after delivery.
Causes of HELLP Syndrome
The exact cause of HELLP syndrome in pregnant women is not known. There is a suspicion that the occurrence of this condition is triggered by preeclampsia or eclampsia during pregnancy. While other allegations are antiphospholipid syndrome, which is a condition that is at risk of causing blood clots.
The following factors can increase a pregnant woman's risk of developing HELLP syndrome:
- Suffering from hypertension
- Over 35 years old
- Having above normal weight or obesity
- Have a history of HELLP syndrome in a previous pregnancy
- Suffering from diabetes
- Suffer from kidney disease.
Symptoms of HELLP Sindrom Syndrome
Symptoms of HELLP syndrome vary, such as feeling unwell, easily tired, abdominal pain on the right-upper side, headache, nausea, and vomiting.
Some other symptoms of HELLP syndrome that can also appear are shoulder pain, pain when taking a deep breath, gaining weight more than normal for pregnant women, swelling of the face or arms, to visual disturbances. In rare cases, seizures may also occur.
HELLP Sindrom Syndrome Diagnosis
Doctors will suspect a patient has HELLP syndrome if there are symptoms, which are confirmed by a physical examination. Physical examination includes examination of the abdomen, liver enlargement, or the presence of swollen body parts.
HELLP syndrome often occurs during the 3rd trimester of pregnancy. But in rare cases, HELLP syndrome can occur before entering the 3rd trimester or even occur within 48 hours to one week after delivery.
Symptoms of HELLP syndrome can mimic the symptoms of other illnesses or complications, such as gallstone disease, hepatitis, and blood clotting disorders. Therefore, doctors need additional tests, such as blood tests that aim to measure the number of red blood cells, platelets, and liver enzyme tests.
To make sure a patient has HELLP syndrome, the doctor will perform several tests, which include:
- urine test, to check protein levels in the body.
- MRI, to determine whether there is bleeding in the liver, if there is suspicion in that direction.
HELLP Sindrom Syndrome Treatment
Treatment for HELLP syndrome depends on gestational age and the severity of the symptoms. However, basically immediately removing the baby from the womb is the best way to save the lives of both mother and baby.
At the gestational age of less than 34 weeks, the doctor will first focus on the maturation of lung function in the fetus. Next, it will be decided whether the delivery can be done or not.
The following are forms of handling HELLP syndrome that can be given by a doctor, before the delivery process is ready:
- Complete rest in the hospital, with regular supervision by doctors and nurses
- Monitoring the condition of the fetus through examinations such as biophysical tests using a sonogram, evaluation of fetal movements, and non-stress tests
- Blood transfusions are given when the red blood cell count is below normal
- Giving drugs, such as corticosteroids to accelerate the maturation of the fetal lungs, antihypertensive drugs, to anticonvulsant drugs in the form of magnesium sulfate.
Doctors will try to give birth normally to pregnant women with HELLP syndrome, especially in patients with a healthy cervix and a gestational age of 34 weeks. Delivery by Caesarean section will be avoided because of the risk of causing complications, such as bleeding due to the low number of platelets in the body.
HELLP Sindrom Syndrome Prevention
In most cases of pregnancy, HELLP syndrome cannot be prevented, because the cause is unknown. However, there are several ways that pregnant women can do to reduce the risk of this condition, namely:
- Live a healthy lifestyle by eating healthy foods, such as vegetables, fruits, protein, and whole grains. Do exercise regularly to avoid diabetes or hypertension.
- Carry out routine pregnancy checks according to the schedule determined by the doctor.
- Immediately see a doctor if you experience symptoms associated with HELLP syndrome, preeclampsia, or eclampsia, so that they can be treated immediately.
HELLP Syndrome Complications
A number of complications of HELLP syndrome are quite serious, including:
- stroke
- Liver rupture or tearing of the liver
- Acute kidney failure
- Respiratory system disorders
- Pulmonary edema (fluid buildup in the lungs)
- Continuous bleeding during labor
- Disseminated intravascular coagulation (disseminated intravascular coagulation/DIC), namely blood clots and bleeding that occur at the same time
- Placental abruption, which is a condition in which the placenta is partially or completely separated from the uterine wall before the time of delivery.
