Epidemiology

"How common is this?"

Now that we've introduced you to HELLP syndrome, this blog is going to take a week by week look a little more in depth at some of the aspects of the syndrome and how prevalent it is, as well as diagnosis and treatment (but more about that later)!

For now lets focus on the epidemiology and prevalence of the disease, and some of the risk factors associated with it.

Reports show that HELLP syndrome can occur in approximately 0.1- 0.6 of all pregnancies, and can occur in 10-20% of women with severe preeclapmsia/eclampsia (AAFP). While normally the symptoms of preeclampsia precede HELLP syndrome helping to lead to it's diagnosis, there can be 15-20% of patients that do not have any hypertension or proteinuria, which can mean a serious delay in diagnosis which can lead to hepatic problems such as infarction, hemorrhage, and rupture. The timing can also be misleading with 31% of patients developing the syndrome in the postpartum period (though symptoms usually onset within 48 hours after baby is born and up to 7 days).

What are some of the risk factors for developing HELLP?

• Sisters and offspring of women with a history of HELLP have been shown to be at increased risk. 
• Previous pregnancy with HELLP syndrome

Other factors include:

• Over age 30
• Caucasian
• Obesity
• Multiparous
• Poor diet
• Diabetes

In comparison with preeclampsia, those mothers to be under the age of 20 or over the age of 45, nulliparous, and have histories of high blood pressures.

While there is quite a bit of crossover, these of some of the distinctive factors that separate the two.

Your next questions may be- OK so how exactly does HELLP work within the body? Well, lets look at that next!



http://www.aafp.org/afp/1999/0901/p829.html
http://www.uptodate.com/contents/hellp-syndrome
http://www.healthline.com/health/hellp-syndrome

Introduction

"HELP!! What is HELLP?"

HELLP stands for hemolysis, elevated liver function tests, and low platelet count - it's name was given to represent it's characteristics by Dr. Louis Weinstein in 1982. These are symptoms of the disease that are usually in addition to the symptoms of preeclampsia, which can include high blood pressures, headache, proteinuria, and edema. In other words- you have one sick mama who needs your HELP! The global mortality rate of HELLP is as high as 25% in some areas and as many as 48,000 women a year in the United States are diagnosed with HELLP. While mortality rates are much lower with fast treatment in the United States, it remains a serious diagnosis requiring close monitoring.

HELLP can be a potentially fatal diagnosis and can be difficult to diagnose- especially when high blood pressures and protein in the urine are not present. Since these two conditions don't always present together, and one doesn't always precede the other, this can frequently be misdiagnosed and mismanaged. Sometimes it can be mistaken for gallbladder disease, acute hepatitis, gastritis, or even the flu! Symptoms include:

• Headache
• Nausea/vomiting/indigestion with pain after eating
• Abdominal or chest tenderness and upper right upper side pain (from liver distention)
• Shoulder pain or pain when breathing deeply
• Bleeding
• Changes in vision
• Swelling
• High blood pressure
• Protein in the urine

It is important to know the signs and symptoms and be aware of the disease process to catch it quickly! Depending on how far along the mother is, she could need transfusions (red cells, platelets, plasma) and corticosteroid shots to help develop baby's lungs if early in pregnancy in case of preterm delivery.

This blog will look at HELLP over the next several weeks to help you learn about what to watch for, why it happens, what to test for, and how to best HELP your patient with HELLP!

Sources:
http://www.preeclampsia.org/health-information/hellp-syndrome