A Clinical Study of Hellp Syndrome

Abstract

BACKGROUND HELLP syndrome is an acronym for Haemolysis (H), Elevated Liver Enzymes (EL) and Low Platelet (LP). This is a rare complication of preeclampsia (10-15%). HELLP syndrome may develop even without hypertension. This syndrome is manifested by nausea, vomiting, epigastric or right upper quadrant pain along with haematological changes. Parenchymal necrosis of liver causes elevation in hepatic enzymes (AST and ALT >70 IU/L, LDH >600 IU/L) and bilirubin (>1.2 mg/dL). There may be subcapsular haematoma formation (which is diagnosed by CT scanning) and abnormal peripheral blood smear. Eventually, liver may rupture to cause sudden hypotension due to haemoperitoneum. Periportal haemorrhagic necrosis of the liver occurs due to thrombosis of the arterioles. The necrosis is seen at the periphery of the lobule. There may be subcapsular haemorrhage. Hepatic insufficiency seldom occurs because of the capacity and regenerative ability of liver cells. Liver function tests are especially abnormal in women with HELLP syndrome. A sincere effort has been put to study the HELLP syndrome incidence and its clinical prognosis and to understand its outcome.