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[The HELLP syndrome. Notes on its pathogenesis and treatment]

R D'Anna1

  • 1Istituto di Ginecologia, Università degli Studi, Messina.

Minerva Ginecologica
|April 1, 1996
PubMed
Summary

HELLP syndrome, a serious pregnancy complication involving hemolysis, elevated liver enzymes, and low platelets, can occur postpartum. While pregnancy interruption is often mandatory, some cases may be managed with vasodilatation to improve outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology
  • Critical Care Medicine

Context:

  • HELLP syndrome, characterized by hemolysis, elevated liver enzymes, and low platelets, is a severe complication of pregnancy.
  • Its distinct entity versus a spectrum of pre-eclampsia remains debated.
  • It is associated with significant maternal and perinatal mortality rates.

Purpose:

  • To review the literature on HELLP syndrome, including its incidence, mortality, clinical manifestations, and management.
  • To discuss the pathophysiology involving intravascular platelet activation and micro-angiopathic hemolytic anemia.
  • To evaluate a specific treatment approach involving delayed delivery.

Summary:

  • HELLP syndrome involves thrombocytopenia and micro-angiopathic hemolytic anemia due to intravascular platelet activation.

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  • Hepatic hypoperfusion from endothelial damage and vasospasm causes liver damage.
  • Pregnancy interruption is typically mandatory due to the risk of disseminated intravascular coagulation, though some studies suggest alternative management.

    • Impact:

    • Understanding HELLP syndrome is crucial for timely diagnosis and management to reduce maternal and perinatal mortality.
    • The review highlights the potential for non-surgical management strategies to improve outcomes.
    • Further research is needed to validate alternative treatment protocols for HELLP syndrome.