HELLP Syndrome

Not Feeling Right

At almost 28 weeks pregnant, Michelle Berndt of Nashua, New Hampshire, was having a complication-free pregnancy. Feeling great, eating right, and ensuring time for physical activity, Berndt and her husband were anxiously awaiting the birth of their first child. With less than one week until her next routine prenatal examination, Berndt tried to ignore the signs that something might not be quite right. "I assumed my sudden weight gain was just part of being pregnant and that my chest pain was a bad case of indigestion," she says.

After almost a day of progressively increasing chest pain and difficulty breathing, Berndt relented and agreed to go to the emergency room. "I felt silly," she says. "I thought I should be able to tolerate some heartburn or indigestion."

With no history of high blood pressure or preeclampsia, being diagnosed with Hemolysis, Elevated Liver, Low Platelet Syndrome (HELLP), Berndt and her husband found themselves in a situation they were completely unaware of and unprepared for. Devastated and terrified for the health and safety of both Michelle and their unborn child, the Berndts were reeling from the tests and medication being administered.

They contemplated trying to speed up her delivery with Pitocin®. Berndt's condition continued to deteriorate and she and her husband were told she needed to have an emergency C-section. "I couldn't believe that Michelle had developed such a serious complication that we knew nothing about," says Bill Berndt.

What is HELLP?

HELLP syndrome is a placental disease that is considered to be a variant of the complication preeclampsia. HELLP occurs when vasospasms occur in the body and blood vessels act like a muscle relaxing and contracting. Blood passes through the relaxing and contracting veins, causing damage to a special lining in the veins. As damage occurs, red blood cells and platelets try to heal the damage and create clots over the damage. The clots grow and begin to stress the body as it works to push the blood past this damage. HELLP affects mainly the liver because it is deprived of oxygen due to the clots. Although women of diverse backgrounds and ethnicities have been affected by HELLP syndrome, HELLP occurs earlier and is more prevalent in Caucasian mothers-to-be.

Signs and Symptoms

Although women who have a history of preeclampsia are thought to be at a slightly higher risk for developing HELLP, medical experts agree women do not need to have a history of preeclampsia, and otherwise completely healthy individuals can develop HELLP.

Dr. John T. Repke, professor and chairman of the Department of Obstetrics and Gynecology at Penn State College of Medicine, Milton S. Hershey Medical Center, explains that HELLP indicators may be tough to spot. "Symptoms can be very subtle," says Dr. Repke. "Someone might not feel quite right or HELLP may present as the flu."

A combination of symptoms such as mild to moderate elevation of blood pressure, right upper quadrant pain, excessive weight gain and fluid retention, or bruising easily are reasons to consult your physician. "An otherwise normally healthy individual might not have any history of HELLP or preeclampsia and not realize they are experiencing some of its symptoms," says Dr. Repke.

Encouraging expectant women to temper alertness for HELLP with an empowering attitude to discuss any concerns with their healthcare providers, Dr. Repke urges mothers-to-be to pay attention to their bodies and how they are feeling. "Discussing any concerns with a doctor can ease your mind as well as diagnose a complication," he says.

Dr. Repke also notes you should inform your doctor if you have a first-degree relative such as your mother or sister who had preeclampsia. "This can slightly increase a woman's chances of developing preeclampsia or HELLP," he says.