Hellp Syndrome: a serious pregnancy complication?

What is Hellp Syndrome?

Hellp syndrome designates hepatic involvement combining hemolysis, an increase in liver enzymes and a decrease in platelets.It occurs in the second part of the second trimester of pregnancy or in the third."Most often, it is a serious complication of pre-eclampsia, pathology of pregnancy which is characterized by hypertension and the presence of proteins in the urine (proteinuria), comments Dr. Julia Maruani, medical gynecologistand secretary general of the National Federation of Medical Gynecology Colleges (FNCGM).In 15 % of cases, syndrome manifests without pre-eclampsia.The origin of the Hellp Syndrome remains unknown but we begin to understand the principle of pre-eclampsia, which is linked to a lack of implantation of the trophoblast (the future placenta) from the start of pregnancy ".

What are the syndrome's symptoms?

Hellp syndrome can manifest itself by epigastric pain that radiates in the back, due to the obstruction of the blood vessels of the liver.The other symptoms are those of pre-eclampsia, namely: fairly severe hypertension, proteinuria, nausea, vomiting, edema and weight gain."It is important that this syndrome is detected early to optimize the care of the mother and the child," warns the gynecologist.

How to handle your child's tempestrum. Remember that your child's tantrum is NOT necessarily a… http://t.CO/CHYHFFW2EH

— Winnie Kitaka Thu Mar 20 06:49:26 +0000 2014

What is the diagnosis of Hellp Syndrome?

Hellp syndrome is often diagnosed in women followed for pre-eclampsia.It is confirmed by the blood test which shows hemolysis (destruction of red blood cells), an elevation of liver enzymes and thrombocytopenia (decrease in platelets).

What are the risks of complications from Hellp Syndrome?

The main complication of the Hellp Syndrome is the CIVD (disseminated intravascular coagulation), an abnormality of blood clotting which will lead to both thrombosis (obstructions of the vessels) and hemorrhages."Patients can make brain hemorrhages, liver capsular hematomas or even a liver rupture with internal hemorrhage.It is through this CIVD mechanism that serious complications arise and the risk of maternal mortality, estimated at 10 %.Can also manifest renal failure, lung edema and other various and varied hemorrhages, ”explains Dr. Julia Maruani.

What is the management of Hellp Syndrome?

As soon as the Hellp Syndrome is suspected or the diagnosis has been made, the patient must be taken care of in a level 3 maternity, which has a resuscitation service both maternal and fetal."The only treatment of pre-eclampsia being childbirth, often premature, it is preferable to give birth to the child in a maternity hospital where there is a resuscitation service rather than transfer him after his birth.In addition, it is not uncommon for mothers to end up in resuscitation, "said our interlocutor.In parallel, treatments can be administered to the mother to win a few hours and soothe it:

• Medicines to lower blood pressure,

• a transfusion of platelets if these are too low,

• An injection of corticosteroids for fetal pulmonary maturation if the mother is before 32 weeks to adapt the baby's lungs to the premature birth.

"Most often, the cesarean will take place quickly if the patient has severity criteria or if she is more than 34 weeks of amenorrhea," said Dr. Julia Maruani.If there is a risk of recurrence on the following pregnancies, it is unfortunately not possible to prevent pre-eclampsia and the hellp syndrome, the medical team will be twice as vigilant on tension, proteins,symptoms and pregnancy will be immediately considered at risk.