HELLP Syndrome

Overview

The HELLP syndrome is a serious complication of pregnancy, found most frequently in conjunction with severe preeclampsia. The incidence of this disease in preeclampsia is between 2 and 12%. The diagnosis is based on typical laboratory findings, i.e. haemolysis - H, elevated liver enzymes - EL and a low-platelet count - LP. Haemolysis is defined as microscopic finding of an abnormal peripheral blood smear, elevated total bilirubin above 1.2 mg/dl and elevated lactate dehydrogenase above 40 mkat/l. Transaminases (AST above 4.2 mkat/l) are also elevated. For HELLP a low platelet count is typical (number of thrombocytes less than 100 000 mm 3 ). The symptoms include above all pain in the epigastrium, in the right subcostal area, nausea and vomiting. Non-specific symptoms resembling viroses are lassitude, general weakeness, headache and fatigue. A correct differential diagnosis and early assessment of the diagnosis are decisive for starting treatment which can prevent the development of serious complications such as disseminated intravascular coagulopathies and hepatorenal failure. Treatment of the HELLP syndrome is sympto- matic with the objective to stabilize the general condition of the mother, improved haemodynamic conditions and the impairted haemocoagulation. A very important therapeutic step is early termination of pregnancy which depends on ther mother´s condition and the condition of the foetus with regard to gestational age.

Key words:
HELLP syndrome, incidence, pathophysiology, symptomatology, diagnosis, complications, therapy