HELLP syndrome: termination of pregnancy or C-section?

Hello,

I’m 7 months pregnant and just came home from my OB/GYN office. I just got the news that I’ve developed asymptomatic preeclampsia, which started naturally once I got pregnant. I was experiencing severe headache during past few weeks, and he said this is one of the most common symptoms of preeclampsia. I also gained too many lbs while pregnant and my blood pressure reached 150 over 90 or higher… Moreover, he said I may have developed the HELLP syndrome after many lab tests.

Doctor said the only treatment for the HELLP syndrome is proceeding with the termination of pregnancy, but I’m terrified… do you think I’ll end up losing my baby? He’s now 7 months, it’s almost there… I’d rather die 🙁 I’ve read something about performing a C-section, would it be right for me or what are the requirements?

Please, help me.

Dear tasha,

preeclampsia is a condition that appears during pregnancy, usually in an asymptomatic form, as in your case. This disease progresses silently up until clinical symptoms appear. It may appear within 20 weeks after amenorrhea up until day three after labor. The most common symptoms are: migraine (headache), stomach pain, excessive weight gain during pregnancy, high blood pressure values, etc. Thus, your symptoms are among the most common ones, indeed.

The HELLP syndrome is a condition derived from preeclampsia, which nowadays remains almost unknown for the majority of pregnant women. It is a rare condition, as it develops only in less than 2% of women with preeclampsia while pregnant. The clinical picture of the HELLP’s syndrome usually includes: general malaise, nausea, vomiting, severe stomach pain, fever, and sometimes even liver damage. The only way a woman may have this rare syndrome detected is by communicating these symptoms to her physician, and after carrying out a series of laboratory tests, which will show damaged red blood cells, an abnormal decrease in the number of platelets in the blood, etc.

As your physician determined, the treatment for the HELLP syndrome consists of the termination of pregnancy. However, the first thing your doctor should do is evaluating the health state of the expectant mother. Then, she may be taken to a hospital where an Intensive Care Unit is available. Fetal development and how many weeks pregnant is the woman are also crucial aspects to keep in mind when proceeding with the treatment of HELLP syndrome. If the woman is around 32 weeks pregnant, labor may be scheduled within 24 hours. If the woman is less than 32 weeks pregnant, pregnancy may be extended 2-3 weeks, and the woman may be admitted to the Intensive Care Unit.

Having the HELLP syndrome does not translate into a C-section (caesarian) being the only solution. As I said earlier, it may depend on the week of pregnancy the woman finds herself at the moment and the maturity of the uterine cervix. According to that, childbirth may be induced or not. Nevertheless, the truth is the C-section rates with HELLP syndrome are between 65% and 90%, which are so high. The woman will be monitored also in the puerperal phase to check that everything is fine.

Women who have suffered from HELLP syndrome in her first pregnant should keep in mind that there’s a risk of developing it again in further pregnancies. Such risk usually reaches a 20-30% likelihood, but in cases where this pathology appears from the 7th month of pregnancy onwards, the rate increases to 60% approximately.

I hope I have been able to help,

Regards