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What Ob-Gyns Want You to Know About This Dangerous Pregnancy Complication

Health logoHealth 9/10/2019 Maggie O'Neill
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Pregnancy—while beautiful and natural and all that jazz—comes with its share of strange side effects: morning sickness, fatigue, an inexplicable craving for pickles and peanut butter...together. But, in addition to those pretty comical (albeit uncomfortable) symptoms, being pregnant can also come with its risk of serious complications.

One of those complications you may not know about: a dangerous, and sometimes fatal condition called HELLP syndrome, which affects tens of thousands of women in the U.S. each year. Health spoke to two ob-gyns to learn more about the condition. Here's what you need to know if you're pregnant or thinking about becoming pregnant.

What is HELLP syndrome? 

HELLP syndrome, which is a group of symptoms, stands for hemolysis (a breakdown of red blood cells), elevated liver enzyme levels, and low platelet levels, and the condition affects just under 50,000 women in the U.S. each year, according to the Preeclampsia Foundation. It's essentially a potentially fatal condition that affects a woman's liver and blood. The condition typically strikes during a woman’s third trimester, but can occur as late as seven days after giving birth, Christine Greves, MD, an Orlando-based ob-gyn, tells Health.

Preeclampsia (a pregnancy complication characterized by high blood pressure) and chronic hypertension are risk factors for HELLP syndrome, but some women develop HELLP without showing any signs of those conditions, according to the Genetic and Rare Diseases Information Center (GARD). HELLP syndrome, too, "is an extreme form of the elevated blood pressure in pregnancy,” Dr. Greves says.

According to the U.S. National Library of Medicine (NLM), HELLP syndrome occurs in about one to two out of 1,000 pregnancies, but in women with preeclampsia or eclampsia, the condition develops in 10% to 20% of pregnancies.

Race can increase your risk of developing HELLP syndrome. “African American women have higher rates of hypertension and will therefore have a higher rate of HELLP syndrome,” Iffath Hoskins, MD, an ob-gyn at NYU Langone Health tells Health. Experiencing HELLP syndrome in the past can also up your risk of developing it again, says Dr. Greves.

What are the symptoms of HELLP syndrome? 

Abdominal pain is the most common symptom of HELLP syndrome, says Dr. Greves, but it's not your typical pregnancy achiness. “It’s not [in] the usual location of where you feel pain when you’re pregnant," she says; instead, patients report feeling it right below their sternum or breastbone. Dr. Hoskins gets a little more specific, saying that HELLP syndrome can cause pain under your rib cage on your right side—specifically where your liver is located in your body, since HELLP syndrome can cause fluid to stretch your liver capsule, she says.

Pain, however, isn’t the only symptom to watch out for. Pregnant women experiencing HELLP syndrome might also feel sick, “like you’re about to get the flu,” Dr. Greves says. Additionally, the condition can cause nausea, vomiting, headaches, and blurry vision. Rarely, it can also cause bleeding that is hard to stop and seizures.

How is HELLP syndrome treated—and how is it prevented?

"The treatment is delivery," Dr. Greves says—that means as soon as possible, even if the baby is premature, per the NLM. (Babies are considered premature if they're born prior to the 37-week mark, according to the CDC.) That's because HELLP can progress quickly and become dangerous to both mother and child.

Dr. Hoskins adds that in addition to delivering the baby, “the patient should receive IV magnesium sulfate to prevent seizures.” She also says that if the patient’s blood pressure is so high that she’s experiencing “hypertensive crisis”, medications that lower blood pressure might be recommended. Those medications are also administered if a woman develops HELLP syndrome after giving birth or "provide therapeutic support" to the mother, says Dr. Greves.

As far as protecting yourself from developing HELLP sydrome goes, Dr. Hoskins says that taking baby aspirin each day during pregnancy “has been known to decrease the occurrence" of HELLP syndrome. But you should definitely consult your doctor about your risk and how you, specifically, should best manage it.

When HELLP syndrome is diagnosed early—primarily through proper prenatal care and checkups, when your ob-gyn can track the your pregnancy—the prognosis is good. But if the condition is not treated early, one in four women with HELLP syndrome can develop serious complications (like kidney or liver failure, or placental abruption), and without treatment, a small number can die. “The high blood pressure or bleeding into brain may cause a stroke, [and] death may occur in less than 1% of such patients,” Dr. Hoskins says.

But again, those serious complications are rare. Most often, the condition just need management and medical support, says Dr. Greves—but it's still something all women should be aware of.

Related Video: Study Finds Increased Cases of High Blood Pressure During Pregnancy (Provided by CBS News)

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