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What is HELLP Syndrome?

We look at the signs and symptoms of HELLP Syndrome and why early diagnosis and treatment is so important for pregnant women.

HELLP Syndrome is a rare liver and blood clotting disorder that affects around 1 in 125 women during pregnancy or after giving birth. It is most likely to occur during the third trimester, but around a third of cases occur after the baby is born and occasionally it occurs before 21 weeks of pregnancy.

HELLP Syndrome can be difficult to diagnose and is a very serious condition. It’s therefore important to know what the signs and symptoms are, and to contact your midwife or GP quickly or call NHS 111 if you are worried.

What is HELLP Syndrome?

The letters in the name HELLP stand for each part of the condition:

  • H is for haemolysis – this is where the red blood cells in the blood break down.
  • EL is for elevated liver enzymes (proteins) – a high number of enzymes in the liver is a sign of liver damage.
  • LP is for low platelet count – platelets are substances in the blood that help it to clot.

HELLP Syndrome can be difficult to diagnose, especially when high blood pressure and protein in the urine aren't present. Its symptoms are sometimes mistaken for conditions including gastritis, flu, acute hepatitis and gall bladder disease.

Watch Leigh's video below to find out why it's so important for pregnant women to be aware of the condition and its symptoms so they can receive early diagnosis and treatment.

Symptoms of HELLP Syndrome

The physical symptoms of HELLP Syndrome may seem at first like pre-eclampsia (the two conditions are often related). Pregnant women developing HELLP syndrome have reported experiencing one or more of these symptoms:

  • Headache
  • Nausea/vomiting/indigestion with pain after eating
  • Abdominal or chest tenderness and/or upper right side pain (from liver distention)
  • Shoulder pain
  • Pain when breathing deeply
  • Bleeding
  • Changes in vision
  • Swelling/weight gain

Your midwife or doctor will check for the following signs during your antenatal appointments: 

  • High blood pressure
  • Protein in the urine

The most common reasons for women with HELLP syndrome to become critically ill or die are liver rupture or stroke (cerebral oedema or cerebral haemorrhage). These can usually be prevented when caught in time.

If you or someone you know has any of these symptoms, please see your GP or midwife immediately. If you can’t see them straight away, try your local walk-in centre or accident and emergency department or call NHS 111.

How HELLP Syndrome affects babies

If a baby weighs at least two pounds at birth, they have the same survival rate and health outcome of non-HELLP babies of the same size.

Unfortunately, babies weighing less than two pounds at birth don't fare as well. These babies may need longer hospital stays and will have a higher chance of needing ventilator care because their lungs did not have enough chance to develop in the womb. It is hard to predict the effects that these small babies will encounter at birth and later in life.

Around 1 in 10 babies born to women with HELLP die, and this is often related to their prematurity.

Treatment of HELLP Syndrome

With treatment, the mortality rate of women with HELLP Syndrome is around 1 in 100, although complications can occur in about 1 in 4 women.

The only way to treat the condition is for the baby to be born as soon as possible. Many women suffering from HELLP syndrome will also require a transfusion of some form of blood product (red cells, platelets or plasma).

Corticosteroids can be used to help the baby's lungs mature before pre-term delivery. Some healthcare professionals may also use certain steroids to improve the mother's outcome as well.

What can I do to prevent HELLP Syndrome?

Unfortunately, there's currently no way to prevent this illness. Things that coul help you are:

  • Have regular antenatal check-ups during pregnancy.
  • Inform your midwife about any previous high-risk pregnancies or family history of HELLP Syndrome, pre-eclampsia, or other hypertensive disorders.
  • Understand the warning signs and talk to your midwife or GP immediately or call NHS 111. If you can’t see them straight away, try your local walk-in centre or accident and emergency department.
  • Trust yourself when "something just doesn't feel right".

This article is based on information from The Preeclampsia Foundation.

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

The Preeclampsia Foundation is a non-profit organisation that works towards reducing maternal and infant illness and death due to pre-eclampsia, HELLP syndrome, and other hypertensive disorders of pregnancy by providing patient support, research and education, raising public awareness, and improving healthcare practices.

Action on Pre-eclampsia (APEC) is a national charity which campaigns and lobbies for funds, research and education to support those affected by pre-eclampsia. You'll find lots of information and support on their website.

NHS Choices has information on HELLP Syndrome and pre-eclampsia.

Sands provides support for families who experience stillbirth or neonatal death.

Bliss offers emotional and practical support to families of babies born premature or sick.