Pregnancy Poisoning; HELLP Syndrome

Pregnancy Poisoning; HELP Syndrome

HELP syndrome is a disorder that affects pregnant women during pregnancy. Although HELP syndrome is considered a type of preeclampsia, it also includes preeclampsia. There are still many unknowns about HELP syndrome. The incidence rate during pregnancy is 0.2-0.6%.

HELP Syndrome

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H: hemolysis (hemolysis)

E: elevation of liver enzymes (elevated liver enzymes)

LP: platelet decrease (low platelet)

Mostly Although HELP syndrome is accompanied by preeclampsia, HELP findings may also occur before a diagnosis of preeclampsia is made. The incidence of HELPsyndrome in women diagnosed with preeclampsia is 4-12%. HELPsyndrome can be confused with hepatitis, gallbladder diseases, idiopathic thrombocytic purpura (ITP).

HELP Syndrome Findings

The most common findings:

• Headache
• Gradually worsening nausea and vomiting
• Right upper quadrant pain in the abdomen
• Fatigue and exhaustion

Some findings may also be present in normal pregnancy. These findings:

• Visual disorders
• High blood pressure
• Protein in the urine (proteinuria)
• Edema (swelling)
• Severe headache
• Bleeding

HELP Syndrome Diagnosis

HELP Since the symptoms are confused with the findings and complications of other diseases, blood tests and liver function tests must be performed. Although it occurs in the last 3 months of pregnancy and the first 48 hours after birth, it is rarely seen before the 3rd trimester and until the 7th day after birth.

Blood pressure measurement and proteinuria in the urine are checked. In HELP Syndrome:

• Hemolysis in Red Blood Cells

Abnormality in peripheral smear

Lactate Dehydrogenase > 600 u /l

Bilirubin > 1.2 mg/dl

• Increase in Liver Enzymes

Serum aspartate aminotransferase > 70 u/l

LDH > 600 u/l

• Decrease in platelet count

Cause of HELP Syndrome

The cause of

HELP syndrome is still unknown. Although it is more common in pregnant women with preeclampsia and pregnancy-related hypertension, HELP syndrome can also occur without any signs of preeclampsia. Reasons that increase the risk of having HELP syndrome:

• Having HELP syndrome in previous pregnancies (risk 20-25% in each new pregnancy increases)
• Preeclampsia or pregnancy-induced hypertension
• Pregnant women over 25 years of age
• Multiparous (Women who have given birth 2 or more times)

HELP Syndrome Risks and Complications

If HELP syndrome is not diagnosed and treated, both the mother and It can cause serious problems for the baby. The most serious complications:

• Placenta abruptia
• Pulmonary edema (fluid accumulation in the lungs)
• DIC (very serious internal bleeding due to problems with bleeding factors)
• ARDS (lung failure)
• Rupture of hematoma in the liver
• Acute renal failure
• Blood transfusion
• Infant ARDS
• Intrauterine growth retardation

Maternal mortality rate in HELPsyndrome1.1%. Mortality and morbidity rate in the baby is between 10-60%.

Prevention of HELP Syndrome

Since the cause is unknown, there is no definitive method to prevent it. Early diagnosis and treatment The best way to protect yourself from the serious problems of HELP syndrome is early diagnosis and treatment.

HELP Syndrome Treatment

Birth HELP The best and definitive treatment of the syndrome. Many signs and symptoms disappear 2-3 days after birth. If the gestational age is 34 weeks and above and the situation is getting worse, delivery is given immediately. If less than 34 weeks:

• Hospitalization and bed rest are provided
• Corticosteroid injection is given for lung development
• MgSO4 (magnesium) to prevent contractions sulphate) treatment is started
• If platelet count drops, transfusion is performed
• If there is hypertension, use antihypertensive. �lır
• Fetal development is monitored and birth is given as soon as possible.

If birth is planned before 34 weeks, a cesarean section is performed. At 34 weeks and later, if the cervix is ​​suitable, vaginal birth can be performed.

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