Drug for HELLP syndrome: termination of pregnancy

Article

14. 12. 2017

The period of joyful expectation of a baby can be accompanied by various complications. One of the most difficult ones is so-called HELLP syndrome which can manifest in expectant mothers in the advanced stage of pregnancy. What is it and what are the treatment options?

HELLP syndrome is solely related to the third trimester of pregnancy therefore it belongs to the category of so-called pre-eclampsia. It is a pathologic condition which can but does not have to manifest. Its name is derived from its typical symptoms: H for hypertension – high blood pressure, EL for Elevated Liver Enzymes, LP for Low Platelet - low level of blood platelets.

As well as in pre-eclampsia, the HELLP syndrome in pregnant women is manifested by high blood pressure and swelling; it is accompanied by headaches and pain in the hypochondriac region (because of tense liver) and vision disorder. Laboratory tests show distinctively changed liver enzymes and low level of blood platelets which can result in bleeding.

It is inadvisable to stimulate the symptoms as the serious conditions could develop very quickly in expectant mother. "Essentially, the only way how to solve such a condition is to terminate pregnancy. There is no other option. "It depends on the progress of the conditions - in which stage a woman has arrived - which also relates to the return to a standard condition," states MUDr. Ladislav Krofta, CsC., the experienced doctor from the Institute for Care of Mother and Child in Prague - Podolí and also a specialist in Canadian Medical Care.

Complications related to HELLP syndrome:
 

  • Early termination of pregnancy is linked to severe immaturity of a child.
  • If this condition in a woman develops too quickly (amounting to several days), vaginal delivery is ruled out and Caesarean section is used (c-section).
  • During the c-section or in the early postoperative period a relatively high loss of blood can occur due to a low level of blood platelets - a woman can suffer abdominal or uterine bleeding and surgery is inevitable.
     

It is possible to prevent the risk states taking suitable medication

HELLP syndrome poses serious complications for the woman and fetus. Therefore there exists an effort to select those women with the risk of pre-eclampsia in advance, hence with the HELLP syndrome, which has essential influence on the sickness rate in the woman and (or mortality) child. "Currently, we are using a completely new approach which looks very promising. It is a placental growth factor which can be collected as early as in the 13th week of pregnancy where screening for congenital developmental diseases is performed. If given parameters are abnormal, in this stage and on the basis of the screening we are able to inform the woman of the probability of developing such a disease. I see the main significance in the fact that if a higher risk in the woman is proved, it is possible to start a medication treatment which can significantly postpone an early onset of the risk condition, its clinical manifestation or it is possible to fully eliminate it," MUDr. Krofta explains the new possibilities how to discover the risks in their early stages.

Existing clinical studies have proved that the HELLP syndrome onset can be affected by suitable medication – aspirin administration in the early stage of gravidity (ideally before the beginning of the second trimester). It is aspirin which has a significant influence on micro-circulation; and this serious condition is connected with pathological micro-circulation in the placental bed.

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