HELLP Syndrome

Presented by: Kerolos Adel ID:238102

Under Supervision:-
Dr/Israa El Dsouky
Objectives:

 By the end of this presentation, you will be able to:

1. Understand HELLP Syndrome:
1. Learn what HELLP Syndrome is and how it differs from other pregnancy complications.
2. Recognize the Symptoms:
1. Identify the warning signs and symptoms to ensure early detection.
3. Know the Risk Factors:
1. Understand who is most at risk of developing HELLP Syndrome.
4. Learn About Diagnosis:
1. Understand the tests and criteria used to diagnose HELLP Syndrome.
5. Explore Treatment Options:
1. Discover how HELLP is managed and treated to save the lives of both mother and baby.
6. Raise Awareness:
1. Appreciate the importance of prenatal care and awareness in preventing severe outcomes.
•Conclusion

Out Line
 Objective.
 Introduction
 Definition and Pathophysiology
 Causes and Risk Factors
 Signs and Symptoms
 Diagnosis
 Complications
 Treatment and Management
 Prevention and Awareness
INTRODUCTION

HELLP Syndrome is a rare but life-threatening complication. The name
stands for:
• Hemolysis: This means the destruction of red blood cells, which are
responsible for carrying oxygen throughout the body.
• Elevated Liver Enzymes: This indicates that the liver is under stress or
has been damaged.
• Low Platelet Count: Platelets are crucial for blood clotting, and a low
count increases the risk of bleeding.
 This syndrome is closely linked to preeclampsia, but it is a more
severe form that can develop quickly and affect both the mother and
the baby. If untreated, it can lead to liver damage, bleeding, and other
complications.
 Understanding HELLP Syndrome is important because early recognition
and treatment can prevent severe outcomes. In this presentation, I’ll
explain its causes, symptoms, diagnosis, and treatment in a way that’s
DEFINITION
 HELLP Syndrome is a condition that specifically affects pregnant women,
usually in the third trimester. However, in some cases, it can appear after
childbirth. It involves a combination of:
• Red blood cell destruction (hemolysis),
• Liver damage (elevated liver enzymes),
• And a reduced number of platelets (low platelet count).
 It is considered an advanced complication of preeclampsia, but not all
women with HELLP have high blood pressure.
PATHOPHYSIOLOGY
• Hemolysis: The red blood cells become damaged as they pass through
narrowed blood vessels. This reduces the blood’s ability to carry oxygen,
leading to fatigue, weakness, and other symptoms.
• Elevated Liver Enzymes: When blood flow to the liver is reduced, liver cells
can die or become damaged. This causes the liver to release enzymes into
the bloodstream, which is detected in blood tests.
• Low Platelet Count: The body uses up platelets to try to repair damaged
blood vessels, but this reduces the number of platelets available to stop
bleeding elsewhere.
 This cascade of problems can happen very quickly, making HELLP Syndrome a
medical emergency.
Causes and Risk factors
Causes:
The exact cause of HELLP Syndrome is not fully understood, but it’s believed to
result from poor blood flow to the placenta.
 .
This causes a series of events that
lead to inflammation, damage to blood vessels, and stress on organs like the
liver.
Risk Factors:
•History of Preeclampsia: Women who have experienced preeclampsia in
previous pregnancies are more likely to develop HELLP.
•Chronic Conditions: Pre-existing conditions like high blood pressure,
diabetes, or kidney disease increase the risk.
•Age and Pregnancy Type: Women over 35 years old or carrying multiple
babies (e.g., twins) are at higher risk.
•First-Time Mothers: HELLP is more common in first pregnancies.
SINGE AND SYMPTOMS
 Common Symptoms:
• Abdominal Pain: Severe pain, especially in the upper right side, due to liver
inflammation or stretching of the liver capsule.
• Nausea and Vomiting: Similar to morning sickness but more persistent and
severe.
• Headache and Fatigue: Caused by high blood pressure and reduced oxygen
delivery due to hemolysis.
• Swelling: Particularly in the hands, feet, and face, due to fluid retention.
• Changes in Vision: Blurred vision or sensitivity to light due to high blood
pressure.
 Why It’s Dangerous:
 Many of these symptoms overlap with normal pregnancy discomforts, making it
difficult to recognize HELLP early. That’s why regular prenatal check-ups are
essential.
Diagnosis and
Investigations:
• Laboratory Tests:
• Hemolysis Tests: Look for evidence of red blood cell breakdown.
• Liver Function Tests: Elevated liver enzymes (AST and ALT)
indicate liver damage.
• Platelet Count: A low count confirms a clotting problem.
• Imaging:
• An ultrasound of the liver can help rule out other conditions, like
gallbladder issues, and assess liver health.

• Clinical Criteria:
• HELLP is diagnosed when symptoms are combined with
abnormal lab results. Timing is critical because delays can lead to
life-threatening complications.
COMPLICATIONS
For the Mother:
Liver Damage: This can range from mild liver stress to liver rupture, which is a surgical
emergency.
Bleeding: Low platelets increase the risk of uncontrolled bleeding during delivery or
surgery.
Organ Failure: If left untreated, HELLP can lead to kidney failure or heart problems.
For the Baby:
Premature Birth: HELLP often requires early delivery to save the mother’s life.
Low Birth Weight: Caused by reduced blood flow to the placenta.
Stillbirth: In severe cases, the baby may not survive.
Treatment and Management

 Immediate Interventions:

 Delivery: The only definitive treatment for HELLP is delivering

the baby, even if the pregnancy hasn’t reached full term.

 Stabilization: Medications are given to lower blood pressure

and prevent seizures (magnesium sulfate).

 Supportive Care:

 Blood Transfusions: To replace red blood cells or platelets if

levels are dangerously low.

 Monitoring: The mother is closely monitored in an intensive

care unit (ICU) to prevent further complications.
 Prevention and Awareness
 Prevention:
• Regular prenatal care is the best way to identify risks early.
• Controlling conditions like high blood pressure and
diabetes can lower the risk.
 Awareness:
• Pregnant women should report any unusual symptoms
immediately.
• Healthcare providers should educate patients about the
warning signs of HELLP.
 Summary:-
 HELLP Syndrome is a rare but serious pregnancy complication that
involves hemolysis (destruction of red blood cells), elevated liver
enzymes, and low platelet count. It’s commonly linked to
preeclampsia but can also occur without it. The exact cause is
unclear, but it’s believed to be related to poor blood flow to the
placenta.
 Symptoms include upper abdominal pain, nausea, vomiting,
headaches, swelling, and vision changes. Diagnosis is made through
blood tests measuring liver function, red blood cell breakdown, and
platelet count.
 Treatment requires immediate delivery of the baby, regardless of
gestational age, and supportive care for the mother, including
medications and blood transfusions.
 Early detection and intervention are key to preventing severe
complications for both mother and baby. Regular prenatal care and
awareness of symptoms are essential for better outcomes.
 References:-
1. Hauth, J.C., & Sibai, B.M. (2004). HELLP syndrome: a critical review.
Obstetrics & Gynecology, 103(5), 981-991.
2. Lawn, J.E., & Cousens, S. (2004). A systematic review of the
epidemiology and management of HELLP syndrome. Lancet, 363(9405),
575-584.
3. Martin, J.N., & Thigpen, B.D. (2008). HELLP syndrome: pathophysiology,
diagnosis, and treatment. American Journal of Obstetrics and
Gynecology, 199(1), 1-11.
4. Miller, S., & Sibai, B.M. (2004). HELLP syndrome: a review. Obstetrical &
Gynecological Survey, 59(3), 173-183.
5. American College of Obstetricians and Gynecologists (ACOG) (2021).
Hypertension in pregnancy: ACOG Practice Bulletin No. 203. Obstetrics &
Gynecology, 137(2), e56-e64.