Advertisement

What Are the Implications of Abdominal Pain in Preeclampsia and HELLP Syndrome?

  • Joelle Borhart
  • Caroline Massarelli
Chapter

Abstract

Preeclampsia and HELLP syndrome are serious pregnancy-associated conditions with high maternal and neonatal morbidity and mortality. In a pregnant patient greater than 20 weeks gestational age, epigastric or right upper quadrant abdominal pain can be a symptom of preeclampsia or HELLP and must be investigated fully. Temporizing treatment centers on controlling blood pressure and reducing the risk of eclampsia. Since the only definitive treatment of these conditions is delivery, early obstetric consultation is critical.

Keywords

Preeclampsia HELLP Abdominal pain Pregnancy Hypertension 

References

  1. 1.
    Wallis AB, Saftlas AF, Hsia J, et al. Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987–2004. Am J Hypertens. 2008;21:521–6.CrossRefGoogle Scholar
  2. 2.
    Redman C. Preeclampsia: a complex and variable disease. Pregnancy Hypertens. 2014;3:241–2.Google Scholar
  3. 3.
    Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management: a review. BMC Pregnancy Childbirth. 2009;9:8.CrossRefGoogle Scholar
  4. 4.
    Kennedy A. Assessment of acute abdominal pain in the pregnant patient. Semin Ultrasound CT MR. 2000;21(1):64–77.CrossRefGoogle Scholar
  5. 5.
    Sibai BM, Ramadan MK, Usta I, Salama M, Mercer BM, Friedman SA. Maternal morbidity and mortality in 442 pregnancies with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome). Am J Obstet Gynecol. 1993;169:1000–6.CrossRefGoogle Scholar
  6. 6.
    Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998;179:1359–75.CrossRefGoogle Scholar
  7. 7.
    American College of Obstetricians and Gynecologists. Committee opinion no 623: emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2015;125:521–5.CrossRefGoogle Scholar
  8. 8.
    Duley L, Gulmezoglu AM, Henderson-Smart DJ, et al. Magnesium sulfate and other anticonvulsants for women with preeclampsia. Cochrane Database Syst Rev. 2010;11:CD000025.Google Scholar
  9. 9.
    Mol BW, Roberts CT, Thangaratinam S, et al. Preeclampsia. Lancet. 2016;387(10022):999–1011.  https://doi.org/10.1016/S0140-6736(15)00070-7.CrossRefPubMedGoogle Scholar
  10. 10.
    Repke JT, Norwitz ER. Management of eclampsia. In: Heazell A, Norwitz ER, Kenny LC, et al., editors. Hypertension in pregnancy. New York: Cambridge University Press; 2011. p. 141–58.Google Scholar
  11. 11.
    American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstet Gynecol. 2013;122:1122–11.CrossRefGoogle Scholar
  12. 12.
    Olsen-Chen C, Seligman NS. Hypertensive emergencies in pregnancy. Crit Care Clin. 2016;32:29–41.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Joelle Borhart
    • 1
  • Caroline Massarelli
    • 2
  1. 1.Department of Emergency MedicineMedStar Washington Hospital Center & MedStar Georgetown University HospitalWashington, DCUSA
  2. 2.Georgetown University School of MedicineWashington, DCUSA

Personalised recommendations