Treatment Options

 

"HELP! I have HELLP! What now?"

Say your doctor has assessed you, run tests, and has now determined that you do have HELLP syndrome. So how do you proceed? What can you expect?

Depending on many factors, the doctor will decide to treat you preemptively, cautiously in the hospital, or determine that you need to be delivered for the safety of you and the baby.

The most common major options for treatment are as follows:

* If you are more than 34 weeks pregnant, current recommendations are to deliver you immediately for the health of both you and your baby. The risk of continuing pregnancy with treatment does is more than  possible benefit that you will resolve your HELLP and recover after delivery, and that your baby will be healthier outside the womb.

*For women between 27 and 34 weeks of pregnancy, the focus will be stabilization of the mothers clinical condition and starting steroid therapy, as well as treatments with magnesium sulfate, platelet infusion, blood pressure medications, and tests for baby such as biophysical profiles, ultrasounds, and non-stress tests to monitor fetal wellbeing. Then reevaluating within 48 hours for the need to deliver to resolve symptoms.

*Before 27 weeks gestation, focus will be on conservatively managing mothers condition with the above treatments, but treatment will vary based on condition and provider preference and policies.

While immediate delivery usually consists of a c-section for moms who are less than 34 weeks, if a mom is further along and both mom and baby will tolerate, a trial of labor for vaginal delivery may be attempted before rushing to surgery.

The other thing to keep in mind is that while delivery of the infant is the cure, symptoms can increase for the first 24-48 hours, before beginning to resolve at 3-4 days post partum. Rarely the condition can continue into the first week or two.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654858/

http://americanpregnancy.org/pregnancy-complications/hellp-syndrome/

http://www.aafp.org/afp/1999/0901/p829.html

treatment diagram: http://www.aafp.org/afp/1999/0901/p829.html