Skip to main content

HELLP Syndrome

  • Chapter
  • First Online:
Principles of Critical Care in Obstetrics

Abstract

The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5–0.9 % of all pregnancies and in 10–20 % of cases with severe preeclampsia.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103:981–91.

    Article  PubMed  Google Scholar 

  2. Sibai BM. Imitators of severe pre-eclampsia/eclampsia. Clin Perinatol. 2004;31:835–52.

    Article  PubMed  Google Scholar 

  3. Martin JN, Brewer JM, Wallace K, Sunesara I, Canizaro A, et al. Hellp syndrome and composite major maternal morbidity: importance of Mississippi classification system. J Matern Fetal Neonatal Med. 2013;26(12):1201–6.

    Article  PubMed  Google Scholar 

  4. Yıldırım G, Güngördük K, Aslan H, Gül A, Bayraktar M, et al. Comparison of maternal and perinatal outcomes of severe pre-eclampsia, eclampsia and HELLP syndrome. J Turk Ger Gynecol Assoc. 2011;12(2):90–6.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ciantar E, Walker JJ. Pre-eclampsia, severe pre-eclampsia and hemolysis, elevated liver enzymes and low platelets syndrome: what is new? Womens Health. 2011;7(5):555–69.

    CAS  Google Scholar 

  6. Steinborn A, Rebmann V, Scharf A, Sohn C, Grosse-Wilde H. Soluble HLA-DR levels in the maternal circulation of normal and pathologic pregnancy. Am J Obstet Gynecol. 2003;188:473–9.

    Article  CAS  PubMed  Google Scholar 

  7. Agatisa PK, Ness RB, Roberts JM, Costantino JP, Kuller LH, McLaughlin MK. Impairment of endothelial function in women with a history of preeclampsia: an indicator of cardiovascular risk. Am J Physiol Heart Circ Physiol. 2004;286:H1389–93.

    Article  CAS  PubMed  Google Scholar 

  8. Araujo AC, Leao MD, Nobrega MH, et al. Characteristics and treatment of hepatic rupture caused by HELLP syndrome. Am J Obstet Gynecol. 2006;195:129–33.

    Article  PubMed  Google Scholar 

  9. Romero R, Chaiworapongsa T. Preeclampsia: a link between trophoblast dysregulation and an antiangiogenic state. J Clin Invest. 2013;123(7):2775–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Holub M, Bodamer OA, Item C, Mühl A, Pollak A, Stöckler- Ipsiroglu S. Lack of correlation between fatty acid oxidation disorders and haemolysis, elevated liver enzymes, low platelets (HELLP) syndrome? Acta Paediatr. 2005;94:48–52.

    Article  CAS  PubMed  Google Scholar 

  11. Sibai BM. Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count. Obstet Gynecol. 2004;103(5 Pt 1):981–91.

    Google Scholar 

  12. Serdar A, Fırat E, Ark C, Aydın CA. Partial HELLP syndrome: maternal, perinatal, subsequent pregnancy and long-term maternal outcomes. J Obstet Gynaecol Res. 2014;40(4):932–40.

    Article  Google Scholar 

  13. Martin JN. Milestones in the quest for best management of patients with HELLP syndrome (microangiopathic hemolytic anemia, hepatic dysfunction, thrombocytopenia). Int J Gynaecol Obstet. 2013;121(3):202–7.

    Article  PubMed  Google Scholar 

  14. Qureshi NS, Tomlinson AJ. Prenatal corticosteroid therapy for elevated liver enzyme/low platelet count syndrome: a case report. J Reprod Med. 2005;50:64–6.

    PubMed  Google Scholar 

  15. Sultan P, Butwick A. Platelet counts and coagulation tests prior to neuraxial anesthesia in patients with preeclampsia: a retrospective analysis. Clin Appl Thromb Hemost. 2013;19(5):529–34.

    Article  PubMed  Google Scholar 

  16. Vigil-De GP. Maternal deaths due to eclampsia and HELLP syndrome. Int J Gynaecol Obstet. 2009;104(2):90–4.

    Article  Google Scholar 

  17. Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management. A review. BMC Pregnancy Childbirth. 2009;9:8.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Prakash J. The kidney in pregnancy: a journey of three decades. Indian J Nephrol. 2012;22(3):159–67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Sibai BM. Evaluation and management of severe preeclampsia before 34 weeks’ gestation. Am J Obstet Gynecol. 2011;205(3):191–8.

    Article  PubMed  Google Scholar 

  20. Mamouni N, Bougern H, Derkaoui A, Bendahou K, Fakir S, et al. HELLP syndrome: report of 61 cases and literature review. Pan Afr Med J. 2012;11:30.

    PubMed  PubMed Central  Google Scholar 

  21. Haram K, Svendsen E, Abildgaard U. The HELLP syndrome: clinical issues and management: a review. BMC Pregnancy Childbirth. 2009;9:8. doi:10.1186/1471-2393-9-8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Martin Jr JN. Milestones in the quest for best management of patients with HELLP syndrome. Int J Gynecol Obetet. 2013;12:202–7.

    Article  Google Scholar 

  23. Burwick RM, Feinberg BB. Eculizumab for the treatment of preeclampsia/HELLP syndrome. Placenta. 2013;34:201–3.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. K. Shah .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer India

About this chapter

Cite this chapter

Shah, P.K., Daigavane, M., DSouza, N. (2016). HELLP Syndrome. In: Gandhi, A., Malhotra, N., Malhotra, J., Gupta, N., Bora, N. (eds) Principles of Critical Care in Obstetrics. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2692-5_28

Download citation

  • DOI: https://doi.org/10.1007/978-81-322-2692-5_28

  • Published:

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-2690-1

  • Online ISBN: 978-81-322-2692-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics