Scary Shit Series – HELLP

We’ve previously covered preeclampsia on the blog and HELLP syndrome is a variant of that. HELLP is basically preeclampsia’s asshole, homicidal cousin.

It’s pretty rare, but very serious which is why we decided to write about it. HELLP syndrome shows up in about 1 or 2 of every 1,000 pregnancies. If you have preeclampsia, you have about 10-20% chance of developing HELLP syndrome (but you can get HELLP without developing preeclampsia first). About 1 in 4 women develop serious complications from HELLP and some of those women die, hence why this is some scary shit.

HELLP stands for:

H (hemolysis, when red blood cells break down so they can’t properly carry oxygen from your lungs to the rest of your body)

EL (elevated liver enzymes, which is super bad for your liver)

LP (low platelet count, which means your blood can’t clot properly)

To break that down further: your liver stops being able to effectively process toxins in your body and not being able to form blood clots means you could hemorrhage during delivery. Basically some very core systems get all screwed up and it is really bad news for your poor body.

We still aren’t sure exactly what causes HELLP syndrome. Symptoms usually crop up during pregnancy, typically during the third trimester, but for some women, HELLP isn’t diagnosed until childbirth or the few days after giving birth.

Symptoms include:

  • headache
  • nausea
  • fatigue
  • blurred vision
  • swelling in hands, face, and eyes, in particular
  • pain under ribs or in your shoulder (caused by an enlarged liver)
  • high blood pressure
  • protein in the urine

Many of those symptoms are preeclampsia giveaways, too. The reason HELLP is such a tricky bugger is that it can sometimes be present without (or before) preeclampsia and some of the symptoms look a lot like the flu or gallbladder disease. So a woman’s blood pressure is fine and there are no proteins in her urine and then suddenly out of nowhere HELLP rears its ugly head.

Early and fast treatment of HELLP is super critical. Similar to preeclampsia, treatment for a pregnant woman is typically: let’s get that baby out of you! You may also need a blood transfusion to replenish your busted up red blood cells, as well as medication to lower your blood pressure and anti-seizure medication.

I want to be clear that there’s nothing you can do to prevent HELLP. As Amy mentioned in the preeclampsia post, you don’t have to feel really sick to be really sick. What you can do is go to your regular prenatal checkups to have your pee and blood pressure checked and know the warning signs. Trust yourself if you think things feel wonky and then call your practitioner.

If you want more info on HELLP syndrome, check out the page further describing the syndrome on

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  • Thank you so much for writing about this. I had HELLP, but blessedly relatively late in my pregnancy. Baby and I made it to 38.5 weeks.
    I had crazy high BP, I’m normally corpse low so it was wild seeing those numbers, and some swelling. But as a still exercising and on my feet kindergarten teacher thought nothing of the swelling.
    Having weekly urine tests and blood tests once my BP skyrocketed let my midwives catch it the minute my liver started to conk out.
    I refrained from googling HELLP whilst strapped to my magnesium drip and am glad I didn’t know that 25% stat. We managed a lovely (terrifying) vaginal delivery and despite some severe blood loss everything was good.

    Pre-e gets all the attention, but it’s important for mamas to know about these symptoms too.

  • My water broke a month early and I had to be put under for an emergency c-section, which I was later told was because of HELLP. I spent 3 days in the icu and 10 days in the hospital because my liver and kidneys were not functioning. My blood pressure was never high and the week before I felt like I had the flu. I visited my OB the day my water broke and no one seemed too concerned. Ladies, bottom line, if you think something is wrong, insist on being checked. Thankfully me and my little boy are okay, but some women aren’t so lucky.

  • This is the best, most easily understood article on HELLP I have seen. Thank You! I was diagnosed with HELLP at 27 weeks and had an emergency C 2 days later. Thankfully Mommy and Baby are both fine. Scary shit is right! I (thankfully) didn’t know how dangerous it was until after delivery. My only symptom was pain in my upper right belly, my liver. I had told 2 different doctors and a nurse call center about the pain and they brushed me off as heartburn. Delayed my diagnosis about a week, I ‘m extremely lucky to be okay. I don’t think Doctors know about HELLP either! Articles like this will save lives. Ladies, trust your instincts. I knew heartburn wasn’t supposed to hurt that bad. A blood test was all it took to show what was really wrong. Thank you again. Happy Healthy Babies <3

  • I also had HELLP and both my son and I almost died. (Not exaggerating at all) I had no symptoms what so ever or so I thought. Looking back maybe I might have had one not on the list. I had a tiny little scratch that took forever to stop bleeding. But I didn’t think much of it since pregnant women have so much more blood pumping through there system. Otherwise nothing. Be safe, and don’t wait if something doesn’t feel right.

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