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. 

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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  • I am a HELLP survivor but unfortunately I lost my son at 27 weeks due to HELLP and possibly marginal insertion of the umbilical cord on the placenta. I had zero obvious symptoms. Just two weeks before I went to the hospital I had visited my OBGYN and had no protein in my urine and my BP was awesome. The reason I went in was because I had realized I hadn’t felt the baby move in a few days and couldn’t find his heart beat with a home doppler. My husband was the one the encouraged me to go to the hospital for peace of mind and we are lucky that he did. While it is tragic and I am sad every day that we lost our son, the outcome could have been worse. Looking back my only symptoms were my swollen feet were not going down at night whereas they did before and my DR was not concerned about the swelling on its own since my BP was fine. I also had a pain in my back between my shoulders which I attributed to having to sleep on my side and having bad posture at work where I sit all day. It just felt like sore muscles and nothing else. All I can suggest is pay very close attention to your body and if something feels even a little off do not ignore it. Don’t worry about being a bother or hypochondriac. Its better to be safe and know for sure.

  • What is the difference in symptoms between this and choleostasis? I know they’re both liver related, but that’s about it.

    • Yup, you’re right, they are both related to the liver. My understanding of choleostasis is that it happens when the liver is blocked so bile actually starts to overflow into the bloodstream and the primary symptom is itchy hands and feet. So, unlike HELLP, choleostasis patients don’t have issues with platelets or blood pressure. I think we’ll add choleostasis to our Scary Shit list as a future post! Thanks!

  • HELLP survivor here! The only symptom I had was elevated blood pressure, and that was only when laying on my side. When laying on my back, it was normal. Thank God for the doctor who decided to have me change positions and check it again, otherwise we never would’ve known about it. She said that with my bloodwork numbers, I should have had kidney pain, a bad headache and more but I felt completely normal. I had an emergency C-section and we’re both fine. I had never even heard of HELLP before that and I never had pre-eclampsia, so it was very shocking and scary!

  • At 30w pregnant with twins, I was diagnosed with both PE and HELLP. I was a mess, and my DH was across an ocean at the time. Amazingly, they managed to stabilize me for another 2.5 weeks before they had to pull the plug, as my liver and only kidney (having had one removed years earlier) were failing. My twins were 3lb5oz each and feisty as alley cats, and only spent a month in the NICU in order to grow. It was an extraordinary time, and I was literally living from blood test to blood test. I urge anyone who is at risk (or even if you aren’t) to check your BP and keep an eye out for any symptoms.

  • I just wanted to note that there have been some links found between having Celiac Disease (usually undiagnosed or only appearing during pregnancy) and HELPP.

  • Thank you for writing about this. I am a HELLP syndrome survivor, but barely. It almost killed me, and only my doctor and his partner caught it and saved my life. There are Promise Walks to raise money and awareness for preeclampsia and HELLP around the country. There is also a documentary coming out sometime next year called Under Pressure- search it on Facebook!

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