pregnant woman sitting on the bed with HELLP syndrome
Scary Shit Being Pregnant

Scary Shit Series - HELLP Syndrome

By Claire Goss

We’ve previously covered preeclampsia 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.

HELLP Syndrome 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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