7.2 HELLP syndrome

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Presents with abnormal liver tests and right hypochondrium pain in the pregnant patient. HELLP syndrome occurs in 1 in 1000 pregnancies in the second and third trimester. This is a systemic endothelial dysfunction. HELLP syndrome is part of preeclampsia. This is characterized by proteinuria, edema and increased blood pressure. Biochemically, hemolysis is found (H), increased transaminases above 100 IU/l (EL: Elevated Liver Tests) and decreasing platelets < 100000. Endothelial dysfunction can lead to liver hematomas due to rupture. This gives a mortality of 1 to 3% in the mother and 30% in the child. Treatment consists of addressing preeclampsia and early induction of labor.

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