What is HELLP?Pregnancy and the arrival of a new baby is a time of great excitement and joy for expectant parents. However, occasionally there can be complications, which is why pregnant moms should have regular health checks and be aware of any unusual symptoms that may develop.
Over the past few years, there has been discussion around a condition known as HELLP Syndrome. It’s a life-threatening complication in pregnancy that can be difficult to diagnose. We reached out to Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund and his clinical team, to get some answers and advice about HELLP.
What is HELLP Syndrome?
HELLP (Haemolysis, Elevated Liver enzymes, Low Platelet count) Syndrome usually develops before the 37th week of pregnancy but can occur shortly after delivery. It’s a serious complication that affects the blood and liver.
H = Haemolysis is the breakdown of red blood cells that carry oxygen from lungs to the rest of the body.
EL= Elevated liver enzymes. High levels of these chemicals in the blood can be a sign of liver problems.
LP = Low platelet count. Platelets are little fragments of blood cells that help with blood clotting. A low platelet count can lead to serious bleeding.
What causes HELLP?
‘We don’t know what causes HELLP syndrome,’ says Dr Mkhatshwa, ‘however, you are at risk if you have pre-eclampsia or eclampsia.’ About 1 to 2 in 10 pregnant women (10 to 20 percent) with pre-eclampsia or eclampsia develop HELLP.
Pre-eclampsia is caused by high blood pressure. It usually starts after the 20th week of pregnancy or giving birth. Eclampsia is when pre-eclampsia is uncontrolled and causes seizures. Many women are diagnosed with pre-eclampsia before they have HELLP which is a more severe form of pre-eclampsia.
What are the symptoms / signs of HELLP?
You may feel tired, have pain in the upper right part of the belly, bad headaches and nausea or vomiting. You may also experience swelling, especially of the face and hands and blurry vision. Some women develop HELLP suddenly, without having any signs or symptoms.
If you have any signs of HELLP Syndrome, call your medical practitioner, emergency services or go to a hospital emergency room for medical care right away.
How is HELLP diagnosed?
To find out if you have HELLP Syndrome, your healthcare provider will do a physical exam to check for:
- Belly pain or soreness, especially in the upper right side
- An enlarged liver
- High blood pressure
- Swelling in your legs
Other tests could include:
- Blood tests to check your liver enzyme levels, lactate dehydrogenase and full blood and platelet count with a peripheral smear
- Urinalysis to check for protein in the urine
- A CT scan to see if there’s bleeding in your liver
- Non-stress test or ultrasound to check your baby’s health. A non-stress test checks your baby’s heart rate, in the womb, to see how the heart rate changes when your baby moves. This test is to make sure your baby’s getting enough oxygen. Ultrasound uses sound waves and a computer screen to show a picture of your baby inside the womb
Is HELLP painful?
Symptoms of HELLP include serious pain just below the ribs, or the upper right side of the chest area (where the liver is), shoulder pain or pain when breathing.
How is HELLP treated?
You may be given medication to control your blood pressure and prevent seizures or you may require a blood transfusion to treat anaemia and low platelet levels.
Early birth may be necessary because HELLP complications can get worse and harm both you and your baby – either through an induced labour or by C-Section depending on the health assessment results of the baby.
How does it impact the baby?
Infants born to mothers with HELLP Syndrome may have a variety of birth injuries: Intrauterine growth restriction (IUGR) or severe respiratory distress.
Are there long term effects of HELLP?
A history of HELLP Syndrome means you are at increased risk for recurrent pre-eclampsia and HELLP Syndrome as well as increased long-term morbidities, particularly depression and chronic hypertension.
Can HELLP develop after childbirth?
Yes, up to 30% of all patients who develop HELLP Syndrome do so after giving birth, typically within 48 hours.
Can I have another baby after HELLP syndrome?
If you had HELLP in a previous pregnancy, regardless of the time of onset, you have a greater risk for developing it in future pregnancies.
‘The condition is serious but rare’, stresses Dr Mkhatshwa. ‘Throughout your pregnancy it’s important to understand the changes your body is going through and to discuss any unusual pain or symptoms with your medical practitioner. This will ensure you receive the right help especially if you develop a complication and make the pregnancy and birth the joyous event it should be!’
Parenting Hub is one of South Africa’s largest online lifestyle magazines, targeted toward Parents.
We understand that there are many aspects that encompass a Mother, Father or Child and strive toward providing resources and services that accommodates this.
Our content is aimed to inform and educate families on issues starting from pregnancy through to the challenges of the teen-age years.
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Veganism and pregnancyVeganism is becoming an increasingly popular lifestyle which abstains from the consumption and use of animal products, predominantly for health, and/or ethical reasons. If you’re vegan and are considering pregnancy, or are pregnant, you are probably wondering how to best provide nutrients for your growing baby, and if veganism is still the best option for both of you.
Can I stay vegan while pregnant?
Veganism is often criticised for its lack of certain vitamins and minerals that a typical ‘balanced’ diet contains. Luckily, it is still possible to stick to your vegan diet during pregnancy – you’ll just have to make sure that your growing baby receives the nutrients that she needs.
While pregnant, it’s important to eat foods that contain folic acid (a B vitamin), calcium, vitamin D, iron and protein – you can get this from the food you eat as well as supplements. If you’re wondering where you can find these important nutrients in a plant-based diet, read on.
Citrus fruits, dried beans and leafy green veggies are all foods that include folic acid. Typically dairy is a source of calcium, however, non dairy foods rich in calcium are broccoli and kale. Vitamin D can be found in mushrooms and fortified products, such as rice milk and soy milk. Although meat is often seen as a primary source of protein, beans, peas, nuts and seeds are all rich in protein. Potatoes and tofu are also good foods to eat when replacing meat protein, and iron can be found in spinach and beans.
What nutrients are typically lacking in a vegan diet?
As a vegan, there are certain nutrients that you can’t find in plants – during pregnancy it becomes even more important to supplement these. Vitamin B12 (which helps with proper brain development), vitamin D (which aids bone and teeth development), omega 3 fatty acids and iron (you’ll need about twice as much when pregnant) are vitamins and minerals you might need to supplement.
Even if you’re not vegan, making sure your baby gets all the correct nutrients is important and may mean adjusting your diet. If you are planning on sticking to a strict diet plan it’s a good idea to consult with someone knowledgeable first.
Parenting Hub is one of South Africa’s largest online lifestyle magazines, targeted toward Parents.
We understand that there are many aspects that encompass a Mother, Father or Child and strive toward providing resources and services that accommodates this.
Our content is aimed to inform and educate families on issues starting from pregnancy through to the challenges of the teen-age years.
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Should I be exercising while pregnant, and if so, how much?For most exercise is a part of life, so it is natural to want to keep active for as long as possible while pregnant. You may wonder how much exercise you can keep doing as your baby develops, and what routine changes you’ll need to make as your baby grows bigger.
If you have a complicated pregnancy or are dealing with a weak cervix, a low placenta or suffering from a heart condition, diabetes or asthma, it is best to consult with a doctor or health professional before putting together a pregnancy exercise plan.
What are the benefits of exercise during pregnancy
Improving overall health and wellness, exercise is a vital part of keeping you feeling your best and can help with backache caused by pregnancy, as well as prepare you for labour and delivery.
If you were active before your pregnancy, you should be able to keep training with modifications made to your program. Exercises that are low impact and carry small risk of injury are best and you should be able to remain active until birth.
Exercising during pregnancy can help boost your mood and energy levels, improve muscle tone, strength and lessen back pain. Exercise can also help reduce fatigue and stress, as well as help improve your sleep, all of which helps make your pregnancy easier on your body and mind.
Staying fit can also help shorten your post delivery recovery time, however, getting back into exercise postpartum can be difficult and you should avoid pushing yourself too hard in the beginning.
Exercising during pregnancy isn’t only good for your overall wellness, but studies show that it can also improve your baby’s health.
What type of exercise should I be doing?
During pregnancy it is important to keep tabs on how your body is feeling. If you have been exercising frequently pre-pregnancy it should be fine to continue to do so in moderation, however, if something feels strange or uncomfortable it is best to consult a health practitioner.
Swimming, prenatal yoga and pilates, walking and water aerobics are all exercises that you can focus on during your pregnancy. Water activities are good as they give you buoyancy and put very little strain on your body, especially when you are close to giving birth.
If you were an avid runner before, you should be able to continue into pregnancy with some alterations to your program.
Exercise to avoid
High impact sports with a risk of falling should be avoided. These include horse riding, mountain biking, downhill skiing. Contact sports, such as rugby, kickboxing and soccer are also preferable to avoid as there is a risk of being hit. Scuba diving is a big no-no as the baby has no protection against decompression sickness.
Parenting Hub is one of South Africa’s largest online lifestyle magazines, targeted toward Parents.
We understand that there are many aspects that encompass a Mother, Father or Child and strive toward providing resources and services that accommodates this.
Our content is aimed to inform and educate families on issues starting from pregnancy through to the challenges of the teen-age years.
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