HELLP syndrome

This acronym stands for:

H - haemolysis EL - elevated liver enzymes LP - low platelets

This syndrome can occur in severe pre-eclampsia. It may be a cause of fitting in a pre-eclamptic patient after the placenta has been delivered.

This syndrome may be life-threatenening. Hepatocellular dysfunction leads to enzyme release and necrosis and swelling. This can cause epigastric pain, and, in extreme circumstances, rupture and exsanguination.

• HELLP (Hemolysis, elevated liver enzymes and low platelet count) syndrome
  • cause of thrombocytopenia in pregnancy in about 20% of cases
  • maternal platelet count returns to normal within 3-5 days of delivery
  • HELLP syndrome is a variant of preeclampsia (1)
  • platelet count is usually below 100 × 10^9/l)
  • up to 3% of HELLP cases may result in maternal mortality
  • stillbirth occurs in up to 20% of cases - particularly as a result of placental abruption and preterm delivery

Reference:

1. Parnas M et al. Moderate to severe thrombocytopenia during pregnancy. Eur J Obstet Gynecol Reprod Biol. 2006 Sep-Oct;128(1-2):163-8