What is HELLP syndrome and what are the consequences for the baby?

By (embryologist), (embryologist) and .
Last Update: 01/05/2023

HELLP syndrome is a complication of pregnancy that presents as a triad of symptoms: hemolytic anemia, elevated liver enzymes and thrombocytopenia.

This pathology is considered a variant of preeclampsia and, like the latter, generally appears at the end of pregnancy, that is, in the third trimester. In some cases, HELLP syndrome arises after delivery.

Its prevalence is not very high, between 1 and 2 cases per 1000 pregnancies. In addition, HELLP syndrome most commonly disappears shortly after delivery.

Why is it called gestational HELLP syndrome?

HELLP syndrome is a rare gestational complication, although it can endanger the health of the pregnant woman and her baby. It is characterized by a combination of three effects, whose initials give the syndrome its name:

  • Hemolysis: also known as hemolytic anemia. It is the destruction of red blood cells.
  • Elevated Liverenzymes: causing liver failure.
  • Low platelet levels(Low Platelets): so there will be a clotting problem in the blood.

This syndrome can arise with different signs and cause evolution. At other times, HELLP syndrome does not cause any signs in the pregnant woman.

Symptoms of HELLP syndrome

As mentioned above, the clinical manifestations of HELLP syndrome can appear both before and after delivery. In some cases, this gestational condition arises without causing symptoms in the pregnant woman.

In any case, the most prominent symptoms associated with HELLP syndrome are the following:

  • Headache, shoulder and/or abdominal pain.
  • Fatigue and pain when breathing deeply.
  • Nausea and vomiting.
  • Hypertension
  • Fluid retention and excessive or above normal weight gain.
  • Blurred vision.
  • Bleeding from the nose or other parts of the body.
  • Presence of protein in the urine.
  • Swelling.

However, these symptoms are not unique to HELLP syndrome, but coincide with signs of other medical conditions. This is why HELLP syndrome is sometimes confused with lupus or thrombocytopenia purpura, for example.

Why does HELLP syndrome occur?

The exact cause of HELLP syndrome is not known at this time. However, most specialists consider this condition to be a variant of preeclampsia of pregnancy.

However, there are some factors that increase the risk of developing HELLP syndrome during pregnancy or after delivery. Each of them is listed below:

  • Previous pregnancy with HELLP syndrome.
  • Arterial hypertension.
  • Multiparous.
  • Caucasian ethnic group.
  • Pregnancy at an early age or in adolescence.

Apart from these risk factors, family history, autoimmune diseases and coagulation disorders may also increase the likelihood of developing this pregnancy complication.


Diagnosing HELLP syndrome can be complicated, since the symptoms are often confused with other pathologies such as gastritis, influenza, cholecystopathy, thrombotic thrombocytopenic purpura, acute hepatitis, etc.

The mortality rate of HELLP is close to 25% and, therefore, it is essential that pregnant women are aware of this syndrome and know the symptoms. In this way, they will be able to inform the physician as soon as possible and receive a proper diagnosis and timely treatment.

What are the consequences of HELLP syndrome?

HELLP syndrome can progress and cause multiple complications if not treated correctly. Possible consequences of HELLP syndrome include:

  • Disseminated intravenous coagulation or DIC, which causes bleeding.
  • Pulmonary Edema.
  • Renal and hepatic insufficiency.
  • Premature placental abruption.
  • Stroke.
  • Seizures.

When the life of the pregnant woman or the baby is in danger, the specialist may terminate the earlier delivery date. This would avoid more severe problems. Once delivery occurs, it will take a few days for the HELLP syndrome to disappear.

In any case, if the diagnosis is early, appropriate treatment is received and regular gestational check-ups are performed, there should be no major complications.

Treatment and prevention

Generally, the best treatment for women with HELLP syndrome is to give birth, even if the birth occurs prematurely.

Sometimes it is necessary for the woman to receive blood transfusions, either red blood cells, platelets or plasma. You may also be given corticosteroids to promote the baby's lung development and other types of steroids to improve the pregnant woman's condition. In addition, medications are often prescribed to treat hypertension or magnesium sulfate infusion to prevent seizures.

The survival of babies born prematurely in the event of complications will depend on their birth weight and how developed their organs are, especially the lungs. Most deaths, both fetal and neonatal, are related to placental abruption, placental insufficiency with intrauterine asphyxia and extreme prematurity.

Tips to avoid HELLP syndrome

Although there is currently no certain way to prevent HELLP syndrome, following these tips may be helpful:

  • Being in good physical shape before pregnancy.
  • Perform regular prenatal check-ups as indicated by the specialist monitoring the pregnancy.
  • To know the symptoms of the syndrome and to go or inform the doctor in case of any sign or warning signal.
  • Know and inform the physician of any high-risk history such as previous HELLP syndrome or a family history of HELLP syndrome, pre-eclampsia or other hypertensive disorders.

Women who have suffered from HELLP syndrome in previous pregnancies have a recurrence risk of 20-30%. In addition, this risk increases to 60% if the disease appeared before the seventh month of pregnancy.

FAQs from users

Can I take birth control pills after suffering from Hellp syndrome?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

Yes, birth control pills, or any hormonal contraceptive method, can be safely administered to women who have had HELLP syndrome, unless otherwise instructed by a medical specialist.

What are the possible complications of pre-eclampsia?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

When a woman suffers from pre-eclampsia in pregnancy, it is important to take special care, as complications may develop. Each of these is discussed below:

Delayed foetal growth
in pre-eclampsia, the arteries that supply blood to the placenta are affected. As a result, the baby does not get the right amount of blood and oxygen, as well as nutrients.
Preterm birth
in cases of severe pre-eclampsia it is necessary to bring the due date forward, but it can also happen that the baby is born before the due date.
Placental abruption
this means that the placenta separates from the uterine walls before delivery occurs, leading to a large loss of blood in the woman.
HELLP syndrome
is the destruction of erythrocytes or red blood cells accompanied by an increase in liver enzymes and platelet count.
in the most severe cases of pre-eclampsia leads to eclampsia, which leads to seizures.
Imagen: complications-pre-eclampsia-faq

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HELLP syndrome can be confused with hepatitis B. If you are interested in knowing how they differ, you can visit the following link: What is hepatitis B? Is pregnancy possible?

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Werner Rath, Panagiotis Tsikouras, Patrick Stelzl. HELLP Syndrome or Acute Fatty Liver of Pregnancy: A Differential Diagnostic Challenge: Common Features and Differences. Geburtshilfe Frauenheilkd. 2020 May;80(5):499-507. doi: 10.1055/a-1091-8630. Epub 2020 May 18 (View)

FAQs from users: 'Can I take birth control pills after suffering from Hellp syndrome?' and 'What are the possible complications of pre-eclampsia?'.

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Authors and contributors

 Andrea Rodrigo
Andrea Rodrigo
B.Sc., M.Sc.
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia along with the Valencian Infertility Institute (IVI). Postgraduate course in Medical Genetics. More information about Andrea Rodrigo
 Marta Barranquero Gómez
Marta Barranquero Gómez
B.Sc., M.Sc.
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
Adapted into english by:

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