HELLP Syndrome
Article Sections
Introduction
Hemolysis, Elevated Liver enzymes, and Low Platelet count (HELLP) syndrome is a rare but life-threatening condition that typically presents in the late second/third trimester of pregnancy. Because of the high risk for both maternal and fetal morbidity and mortality, patients require immediate delivery.
Pathophysiology
There is debate about whether HELLP syndrome is a severe form of preeclampsia disease or a separate entity. This is because many patients have associated hypertension and proteinuria, consistent with preeclampsia. However, approximately 20% of patients have no associated hypertension, suggesting a separate entity. In addition, most complications of preeclampsia are due to end-organ damage from hypertension, whereas most complications of HELLP syndrome are related to bleeding from hemolysis and coagulopathy.
Therefore, the exact pathogenesis of HELLP syndrome remains unclear. HELLP syndrome likely has the same initial pathophysiology as preeclampsia, with abnormal placental development that results in decreased placental perfusion and subsequent maternal endothelial injury and systemic inflammation.
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