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HELLP Syndrome

Last Updated November 2023 | This article was created by editorial staff and reviewed by Beth Oller, MD

What is HELLP syndrome?

HELLP syndrome is a rare but serious illness during pregnancy. It is a version of preeclampsia, another pregnancy condition that causes high blood pressure. It causes blood and liver problems in the mother. HELLP stands for the 3 indicators of the syndrome:

  • Hemolysis – This is a breakdown of red blood cells. These carry oxygen from the lungs to the rest of the body.
  • Elevated Liver enzyme levels – High levels can mean there are liver problems.
  • Low Platelet counts – Platelets help the blood clot.

This illness can start quickly. It most often occurs in the last 3 months of pregnancy (the third trimester). It can also start soon after you have your baby. Women who have HELLP syndrome may have bleeding problems, liver problems, and blood pressure problems. Any of these can hurt both the mother and the baby.


The symptoms of HELLP syndrome include:

  • Feeling tired
  • Pain in the upper right part of your belly
  • Bad headaches
  • Nausea or vomiting
  • Swelling, especially in your face and hands
  • Blurry vision
  • Fluid retention and weight gain
  • High blood pressure

Rarely, you may notice bleeding that doesn’t stop easily, including from your nose, gums, or other places. Seizures or convulsions can happen but are also rare.

Many healthy pregnant women also have some of these symptoms late in pregnancy. It may be hard to know for sure if you have HELLP syndrome. Call your doctor right away if you’re experiencing these symptoms.

What causes HELLP syndrome?

Doctors don’t know exactly what causes HELLP syndrome. They also can’t predict who will get it. Any pregnant woman may get this illness.

Most women who will get sick have high blood pressure or preeclampsia before they get HELLP syndrome. You can get HELLP syndrome even if your blood pressure is normal.

You’re more likely to get HELLP syndrome if you’re white and older than 34 years of age. You are at higher risk if you’ve had children before or if you had a problem with a past pregnancy.

How is HELLP syndrome diagnosed?

Your doctor will do a physical exam. They will check for tenderness in your abdomen, especially the upper right side. They will check for an enlarged liver, swollen legs, and high blood pressure. These are all signs that you could have HELLP syndrome.

Your doctor will likely order blood tests. These will show if your liver enzymes are high or your blood platelet count is low. These are common indicators of HELLP syndrome.

Can HELLP syndrome be prevented or avoided?

There is no way to prevent this illness. The best thing you can do is see your doctor regularly. Tell them about any symptoms you are having at every prenatal visit.

If you have HELLP syndrome during one pregnancy, you are more likely have it again during your next pregnancy. The illness is usually less severe the second time. You are also more likely to have HELLP syndrome if you had preeclampsia during a previous pregnancy.


The main treatment for HELLP is to deliver your baby as soon as possible. This may have to be done before your due date. This means your baby may be born prematurely.

Complications from HELLP can develop quickly, putting both you and your baby in danger. If you aren’t too sick, your doctor may wait a few days before delivering your baby. They can give you corticosteroid medicines. This will help the baby’s lungs develop faster before it is born. Other treatments you may receive in the hospital include:

  • A blood transfusion if you have severe bleeding
  • High blood pressure medicines
  • An infusion of magnesium sulfate to prevent seizures

Some women who have HELLP syndrome get very sick. Rarely, the illness can be fatal. Most women who have this illness start to get better a couple of days after their babies are born.

Living with HELLP syndrome

If you are diagnosed early, you will likely be fine. Without early treatment, you may develop complications. These include:

  • Clotting problems that can lead to hemorrhage (excessive bleeding)
  • Fluid in your lungs
  • Kidney failure
  • Liver hemorrhage and failure
  • Placental abruption (when the placenta separates from the wall of the uterus)

Once your baby is born, the illness usually goes away. If you have it once, you are more likely to have it again in future pregnancies.

Questions to ask your doctor

  • I have high blood pressure. Am I at risk for HELLP syndrome?
  • What blood tests do I need?
  • Will I need to deliver my baby early? What risks does this pose for my baby’s health?
  • What would happen if I waited to deliver my baby?
  • I had HELLP syndrome during another pregnancy. Will I have it again? Can I do anything to prevent HELLP syndrome during this pregnancy?
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