Let's be aware of HELLP Syndrome, a rare but serious condition that can occur during pregnancy.

Pregnancy is a very beautiful and hopeful time in every mother's life. However, it is also normal to have some fears and doubts about the health of the baby in the womb as well as about your own health. Most of the time, we have heard about conditions like gestational diabetes and high blood pressure (pre-eclampsia). But today we are going to talk about a rare but serious condition that is very important to recognize early. This is called HELLP Syndrome.

What exactly is HELLP syndrome?

Simply put, HELLP syndrome is a serious complication that can occur during pregnancy, mainly affecting your blood and liver. It most often occurs in the third trimester of pregnancy, between weeks 28 and 40. However, it can sometimes occur at any time during the second half of pregnancy (after week 20). Surprisingly, some mothers can develop HELLP syndrome as early as seven days after giving birth.

This is a very rare condition. It usually affects one or two out of every 1,000 pregnant women. But just because it's rare shouldn't be taken lightly. It can be dangerous for both the mother and the baby.

What does the name HELLP mean?

This is not just a name. The letters HELLP represent three main features of this disease. Let's take a look at what they are.

Are preeclampsia and HELLP syndrome the same thing?

This is a problem that many people have. HELLP syndrome is often considered a severe form of high blood pressure during pregnancy, or preeclampsia . Preeclampsia is a condition during pregnancy in which blood pressure rises and protein is excreted in the urine.

Many mothers with HELLP syndrome also have pre-eclampsia. However, sometimes a person with pre-eclampsia does not have HELLP syndrome. Also, about one in five people with HELLP do not have symptoms such as high blood pressure or protein in the urine . This is why it can sometimes be difficult to diagnose.

What are the symptoms of this condition?

The symptoms of HELLP syndrome can sometimes be similar to those of normal pregnancy or other illnesses, so it's important to be very aware of these symptoms.

• Pain in the upper right abdomen: This is a characteristic symptom of HELLP syndrome. Specifically, it is a sharp pain that occurs on the right side, just below the ribs, where the liver is located.
• Severe headache: Not like a normal headache, but a severe headache that does not subside even with painkillers.
• Blurred vision: Feeling like dots are floating in front of the eyes, difficulty looking at light.
• Nausea and vomiting: While this is normal in early pregnancy, you should be concerned about severe nausea and vomiting in the latter half of the pregnancy.
• Fatigue and fatigue: Extreme tiredness felt even after doing nothing.
• Body swelling (edema) and sudden weight gain: especially swelling of the face, hands, and legs.
• Pain when taking a deep breath: You may feel pain on the right side of the chest.

In very rare cases, these symptoms may also occur:

• Unstoppable nosebleed.
• Convulsions or uncontrolled body movements.

What causes HELLP syndrome? Are there any risk factors?

In fact, doctors still don't know the exact cause of HELLP syndrome. That's what's so scary about it. However, they have identified several factors that increase the risk of developing the condition in some women.

• Having preeclampsia or eclampsia: One in five pregnant women with these conditions may develop HELLP syndrome.
• Having HELLP syndrome in a previous pregnancy: If you had this condition with a previous baby, there is about a 20% risk of it occurring in your next pregnancy.
• Being over 35 years of age.
• Having given birth to at least one child previously.
• Having a history of chronic diseases such as kidney disease, diabetes, or high blood pressure.

What complications can this cause?

If HELLP syndrome is not treated in time, it can cause very serious complications for both mother and baby.

Possible complications for the mother

• Bleeding and clotting problems: Some women can develop a condition called `Disseminated Intravascular Coagulation (DIC).` This means that blood clots form throughout the body and they start to bleed uncontrollably. This can lead to excessive bleeding after childbirth (`Postpartum hemorrhage`).
• Kidney failure: The kidneys can become damaged and stop functioning.
• Bleeding from the liver or liver failure: The liver swells, starts bleeding from within, and the liver can completely lose function.
• Pulmonary edema: This causes difficulty breathing.
• Placental abruption: The placenta separates from the uterine wall before the baby is born. This is very dangerous because it cuts off oxygen and nutrition to the baby.
• Eclampsia: This is the most severe stage of pre-eclampsia. It causes seizures.

Complications that may occur to the baby in the womb

• Preterm birth: Since the only treatment for HELLP syndrome is to deliver the baby, it is often necessary to deliver the baby at term.
• Intrauterine growth restriction (IUGR): The baby does not grow properly in the womb.
• Being born with low platelet counts, anemia, or other blood disorders.
• Respiratory distress.

How does the doctor diagnose this?

When you tell your doctor that you have symptoms of HELLP syndrome, he or she will first examine you physically. Specifically,

• Is there pain in the upper right abdomen?
• Are your legs swollen?

Then your blood pressure will be measured, a urine test will be done to check for protein. Several blood tests will be done to confirm this.

• Complete blood count (CBC) : Checks the number of red blood cells, white blood cells, and platelets.
• Liver function test : Check liver enzyme levels.
• Kidney function test : Checks whether the kidneys are working properly.

If the condition is severe, an ultrasound or CT scan may be performed to check for swelling or bleeding in the liver.

How is HELLP syndrome treated?

If you are 34 weeks pregnant or more, or if your symptoms are very severe, doctors may recommend delivering your baby as soon as possible. This can cause the baby to be born prematurely. HELLP syndrome usually goes away within a few days after the baby is born.

However, if the pregnancy is less than 34 weeks and the mother and baby are stable, doctors will try to buy time for the baby's lungs to mature a little more. During that time, you will be kept in the hospital and given treatments such as:

• Medications to lower blood pressure.
• Blood transfusion if platelet count is low.
• Giving magnesium sulfate to prevent seizures.
• Giving injections of corticosteroids to help the baby's lungs develop faster.
• Blood tests to regularly monitor your liver function and platelet levels.

Throughout this time, doctors constantly monitor the baby's health through tests such as a `biophysical profile`, `nonstress test`, and `ultrasound`.

How does this condition affect the mother and baby?

HELLP syndrome is a serious condition, but it can be cured if diagnosed early and treated properly . If left untreated, it can be life-threatening.

From the mother's perspective, the risk of death is less than 1% if proper treatment is received. Most mothers recover completely within a few days of giving birth.

From the baby's perspective, survival depends largely on gestational age at birth. The longer the baby is in the womb, the better the baby's health is likely to be. Premature birth can cause complications such as breathing difficulties, vision problems, or developmental delays.

Can HELLP syndrome be prevented?

Unfortunately, there is no surefire way to prevent HELLP syndrome. However, the best thing you can do to reduce your risk of complications during pregnancy is to attend regular prenatal care . Your doctor will be monitoring your blood pressure and other signs, so that any problems can be identified early.

If your doctor determines that you are at high risk of developing this condition, he or she may recommend that you take low-dose aspirin after the first trimester (around 12 weeks).

In addition, these things will help you have a healthy pregnancy:

• Eating a nutritious diet (grains, lean protein, fruits, and vegetables).
• Exercising regularly.
• Sleep well for at least 8 hours every day.
• Talking to your doctor about potential health risks during pregnancy.

When should I see a doctor?

If you have preeclampsia or high blood pressure, be very careful about the symptoms of HELLP syndrome. If you have any of the following symptoms, call your doctor immediately.

• Stomach pain on the right side.
• Nausea and vomiting.
• Headache or blurred vision.

HELLP syndrome is a scary condition. But remember, your medical team is doing everything they can to keep you and your baby safe. Early detection is key.