"How the heck does this even happen in the body"?
Well, doctors are still unsure about what exactly causes HELLP syndrome or what happens in the body to trigger symptoms.
One theory is that the same mechanisms that cause preeclampsia or pregnancy induced hypertension are at play. However, the added complications of elevated liver enzymes and decreased platelets are unknown. One theory, is that the cause of preeclampsia is from defective placental remodeling and inadequate placental perfusion. This then causes different factors that cause placental disfunction, resulting in hypertension, proteinuria, increased platelet activation and aggregation. Activating the coagulation cascade causes platelets to adhere onto damaged endothelium, and hemolysis from the sheared erythrocytes as they travel through platelet-fibrin deposit riddled capillaries. This causes damage to multiple organs, and can cause hepatic (liver) necrosis that leads to the liver dysfunction of HELLP.
One theory is that the same mechanisms that cause preeclampsia or pregnancy induced hypertension are at play. However, the added complications of elevated liver enzymes and decreased platelets are unknown. One theory, is that the cause of preeclampsia is from defective placental remodeling and inadequate placental perfusion. This then causes different factors that cause placental disfunction, resulting in hypertension, proteinuria, increased platelet activation and aggregation. Activating the coagulation cascade causes platelets to adhere onto damaged endothelium, and hemolysis from the sheared erythrocytes as they travel through platelet-fibrin deposit riddled capillaries. This causes damage to multiple organs, and can cause hepatic (liver) necrosis that leads to the liver dysfunction of HELLP.
Another theory, is that it stems from maternal immune rejection, from contact with a genetically distinct fetus, which would alter the maternal-fetal immune balance, then causing endothelial dysfunction, platelet activation and aggregation, and hypertension.
Since HELLP is a syndrome with multiple possible abnormalities, there is also classification of HELLP syndrome by how many abnormalities are present. There could be multiple processes going on in the mother playing into effect different abnormalities as part of the bigger problem.
Partial HELLP presents with 1-2 abnormalities, and flu HELLP has all 3. Women with full HELLP are at risk for more severe complications including disseminated intravascular coagulopathy (DIC) and should be candidates for immediate treatment, including delivery within 48 hours.
Partial HELLP presents with 1-2 abnormalities, and flu HELLP has all 3. Women with full HELLP are at risk for more severe complications including disseminated intravascular coagulopathy (DIC) and should be candidates for immediate treatment, including delivery within 48 hours.
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