There are some pregnancy-related illnesses that are associated with increased blood pressure. These so-called "hypertensive" pregnancy diseases include, for example, a hypertension that develops during pregnancy. Elevated or high blood pressure (gestational hypertension) and the Pre-eclampsia. The dreaded HELLP syndrome is also considered a hypertensive pregnancy disorder. The blood pressure does not skyrocket in all affected women - but it does in up to 88 per cent of pregnant women with HELLP syndrome. Blood pressure values of or above 190/110 mmHg are not uncommon.
What is HELLP syndrome?
HELLP syndrome is a rare but very serious complication of pregnancy. It endangers the baby, but also the mum, and is also treacherous because the symptoms you may notice are often difficult to distinguish from other illnesses. The diagnosis can be made on the basis of the altered blood values that have given this disease its name.
The term HELLP is made up of the initial letters of the following English terms, which describe a pure laboratory diagnosis based on a blood test:
➤ H stands for "Hemolysis" (German: haemolysis). This means that the haemoglobin value (Hb value) is too low. Haemoglobin consists largely of iron, colours the blood red and is therefore also known as the red blood pigment. It is important in two ways: firstly for haematopoiesis and secondly for the transport of oxygen through the body. However, if haemoglobin levels are too low, not enough new red blood cells (erythrocytes) can form - and the supply of oxygen to the unborn child is also at risk.
➤ E + L stand for"Elevated Liver enzymes". Translated, this means that the pregnant woman has elevated liver values - which is an indication that the liver is no longer working properly. As a result, the mother's body can no longer be sufficiently "detoxified", which also threatens the life of the child.
➤ L + P are the first letters of Low Platelets and indicate that the platelet count is too low. These platelets play an important role in blood clotting. If they are not present in sufficient quantities, blood clotting is impaired. This can even lead to the failure of various organs.
Taken together, these findings lead to the diagnosis of HELLP syndrome with an often relapsing course. It can become life-threatening for mother and child in a very short time and requires emergency medical treatment. immediate treatment in hospital.
The main symptom, apart from the pain in the right Upper abdomensudden severe or unusual headaches, visual disturbances, nausea and vomiting. This pain in the right upper abdomen is caused by stretching of the liver capsule. It is often accompanied by sensitivity to light.
How do you recognise the danger?
From a medical point of view, high blood pressure can be an initial suspicious sign, but it alone does not justify HELLP syndrome. However, if you feel pain in the upper abdomen, this is an alarm sign. Pain on the right in the area between the belly button and the costal arches is considered a characteristic leading symptom of HELLP syndrome. It is caused by the stretching of the liver capsule. They are often quite violent and can be clearly distinguished from the baby's usual kicks. They can be accompanied by nausea, vomiting and diarrhoea as well as visual disturbances (e.g. double vision, flickering eyes). Increased water retention can also occur. This can be recognised by swelling in the arms or legs or also in the face.
So if you have pain in your upper abdomen, especially in the last trimester of pregnancy, don't hesitate and go to your maternity clinic immediately. A level 1 labour ward is best suited, as the team there is best prepared to deal with this emergency.
What does the treatment look like?
If HELLP syndrome is fully developed, the baby is delivered immediately by caesarean section and the mother receives intensive medical treatment. A few days after the birth, the blood values will normalise again and the affected organs will usually recover completely.
If HELLP syndrome has not yet fully developed and is only progressing very slowly or if the baby is still very immature, it may be possible in certain exceptional cases to halt the progression by means of blood plasma treatment.
How common is HELLP syndrome?
From my article about Pre-eclampsia you already know that only 2 to 5 per cent of pregnant women suffer from it. Of these pregnant women with pre-eclampsia, around 10 to 20 per cent develop HELLP syndrome. To rule this out, a pregnant woman with symptoms of pre-eclampsia is always tested for HELLP syndrome at the same time.
In very rare cases, HELLP syndrome can also occur during pregnancy without pre-eclampsia. However, this only affects 0.1 to 0.2 per cent of pregnant women.
HELLP syndrome can also develop after birth. It occurs postpartum in around 30 per cent of cases. The causes of this have not yet been precisely clarified. However, because HELLP syndrome can also occur in the postpartum period, you should not take the typical symptoms lightly during this time either and it is better to go to hospital once too often than too late.
