What Are The Long Term Effects of HELLP Syndrome?

What is HELLP syndrome?

The acronym HELLP refers to the syndrome’s alterations:

H for Hemolysis, this is the breaking down of blood cells causing anemia.

EL for Elevate Liver enzymes that cause failure in liver function.

LP for Low Platelet count due to the increased use to repair vascular damage.

This disease is considered a, more critical, variant of preeclampsia. Of course, these biochemical characteristics could appear with other preeclampsia characteristics, such as high blood pressure. Nevertheless, HELLP syndrome is more dangerous than preeclampsia and is harder to diagnose. 

In the U.S., about 70% of the cases of HELLP syndrome happen during the last stage of the pregnancy, and the other 30% 48 hours after labor. It is a rare syndrome that affects 1 to 2 of 1,000 pregnancies in the U.S., and without early treatment, 25% of women have serious consequences. The mortality rate is not well established, but it is assumed that it goes from 0 to 24%, while perinatal death (infant death) is up to 37%.

So What is Preeclampsia?

Preeclampsia is another serious pregnancy condition, which could develop after the 20th week of pregnancy. The main characteristics include higher blood pressure (hypertension), and proteins start to appear in your urine, indicating that your kidneys are failing. High blood pressure affects the supply of oxygen to your major organs and the placenta. It puts the mother and the baby in jeopardy, and most of the time pregnant women do not have any symptoms. But if you experience any of these symptoms, talk to your healthcare provider:

• Headaches.
• Blurry vision or light sensitivity.
• Dark spots appear in your vision.
• Right side abdominal pain.
• Swelling in your hands and face (edema).
• Shortness of breath.

Preeclampsia is more common than HELLP syndrome. Among pregnant women in the U.S., 5-8% suffer from preeclampsia, while 15% of those women could subsequently develop HELLP syndrome. 

Are there Physical Symptoms to Look For With HELLP Syndrome?

Well… the first thing you have to know is ONLY if you have the three main syndrome´s alterations, will you be diagnosed with HELLP syndrome. However, if you have 1 or 2 alterations (hemolysis, elevated liver enzymes, or low platelet count) you will be diagnosed with partial (or incomplete) HELLP syndrome, which could eventually develop into a complete HELLP syndrome.

Beyond that, the typical clinical symptoms are:

• Epigastric pain: This is a pain in the right upper side of your abdomen (where your liver is).
• Nausea
• Vomiting

Other less common symptoms are:

• Up to 30–60% of women have headaches.
• Less than 20% of women have vision symptoms.
• Some women claimed to have a fever.

If you feel dizzy, nauseous, have symptoms related to hypertension, or have abdominal pain talk to your doctor. Blood pressure control, lab tests, and guidance from your medical provider during pregnancy are the most important things during pregnancy.

What are the causes of this syndrome?

Sadly, science still has been unable to unravel the causes of HELLP syndrome. It is tagged as a systemic inflammatory disorder that starts with a placental insufficiency (when the placenta does not work properly), which can lead to exaggerated activation of the complement system, a large number of proteins that mark and make pathogens more susceptible to the immune system, and greater hepatic inflammation.

Although the causes are known, having preeclampsia or eclampsia increases the risk of developing HELLP syndrome. One in 5 women who suffer from preeclampsia or eclampsia develop HELLP Syndrome. Other risk factors include:

• Women over 25 years old have an increased risk of developing preeclampsia or HELLP syndrome.
• A history of HELLP syndrome in a previous pregnancy.
• The risk is increased for women who have given birth more than once before.
• White Women have a higher risk than Black Women, Asian and Hispanic.
• Other alterations, such as high blood pressure or diabetes.

Does HELLP syndrome have long-term effects on the baby? or me?

I have to say yes! HELLP syndrome is a life-threatening condition that could have long-term effects on the mother and the baby. This particular syndrome is a variant of preeclampsia, and most of the long-term effects are related to the high blood pressure developed during the crisis. This hypertension could trigger heart problems and strokes later in the mother’s life. 

Alterations in liver function, another critical symptom of this syndrome, could result in considerable damage to this organ. However, postpartum recovery typically occurs within 6 weeks postpartum. Moreover, there are no reports about hepatic long-term effects!

Add to all the above, I must warn you that HELLP syndrome in pregnancy is highly linked to mental health alterations, like depression and anxiety. This is due to many women having babies who either died, had very extended neonatal stays, or poor outcomes due to prematurity.

The effects of HELLP syndrome on your baby can vary depending on your baby’s gestational age, weight at birth, and the complications of the early delivery. And the long-term effects are often related to preterm birth: the earlier the birth, the higher the risk of problems.

What am I supposed to do about that? Can I prevent it?

If you have some of the symptoms we mentioned, contact your doctor as soon as possible! If you are developing this syndrome, your doctor may give you medicine to control your blood pressure and prevent seizures. But, you must know you may need a blood transfusion and may need to give birth as soon as possible! This is because HELLP complications can get worse and harm both you and your baby. 

Sadly, you can not prevent this type of syndrome, but you can make some life changes that help to reduce the risk of getting it!

Some Examples include:

• Improve your diet: eat plenty of fruits, vegetables, and reduce fat intake
• Get in good physical shape: practice regular physical activity.
• Reduce stress & anxiety: practice yoga, mindfulness, or reach out to licensed therapist.
• Regular prenatal care: throughout your pregnancy work with a doctor or midwife to monitor your pregnancy. Discuss your clinical and family history.
• Take aspirin: aspirin can reduce blood clotting and are recommended to diminish the risk of preeclampsia. You must first talk with your doctor prior to taking aspirin as there are risks involved with taking aspirin during pregnancy.

Final Thoughts

This dangerous variant of preeclampsia called HELLP syndrome presents risks during pregnancy and childbirth. It’s challenging to diagnose, and symptoms include epigastric pain, nausea, vomiting, and more. While the exact causes are unclear, factors like age and a history of preeclampsia increase the risk. 

While it has long-term effects on mothers, which include hypertension-related issues, the effects on the babies are related to prematurity. As with many pregnancy syndromes or alterations, prevention is our main tool! By maintaining a healthy lifestyle and discussing risk factors with our doctor, we can reduce the risks and improve the early detection for medical intervention. And thus, reduce the HELLP syndrome’s impact on maternal and fetal health.