HELLP Syndrome

A syndrome of HEMOLYSIS, elevated liver ENZYMES, and low blood platelets count (THROMBOCYTOPENIA). HELLP syndrome is observed in pregnant women with PRE-ECLAMPSIA or ECLAMPSIA who also exhibit LIVER damage and abnormalities in BLOOD COAGULATION.

Also Known As:

Networked: 1479 relevant articles (39 outcomes, 143 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pre-Eclampsia (Preeclampsia)
2.	Hemolysis
3.	Eclampsia
4.	Thrombocytopenia (Thrombopenia)
5.	Hypertension (High Blood Pressure)

Experts

1.	Martin, James N: 16 articles (05/2022 - 01/2003)
2.	Vigil-De Gracia, Paulino: 10 articles (08/2022 - 09/2006)
3.	Wallace, Kedra: 10 articles (01/2020 - 02/2013)
4.	Hupuczi, Petronella: 9 articles (01/2019 - 03/2006)
5.	Rigó, János: 9 articles (04/2012 - 09/2007)
6.	Owens, Michelle Y: 8 articles (01/2016 - 03/2011)
7.	Molvarec, Attila: 8 articles (04/2012 - 03/2008)
8.	Moodley, J: 7 articles (05/2019 - 08/2000)
9.	Pierre, F: 7 articles (06/2015 - 05/2000)
10.	Pourrat, O: 7 articles (06/2015 - 05/2000)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to HELLP Syndrome:

1.	EnzymesIBA 01/01/2023 - "On a d’abord soupçonné une insuffisance hépatique fulminante liée soit à une stéatose hépatique aiguë de la grossesse ou encore à une prééclampsie/syndrome HELLP, en raison d’une élévation des enzymes hépatiques, d’une insuffisance rénale aiguë, d’une thrombocytopénie et d’une baisse de l’hémoglobine, pour lesquelles la patiente a initialement été traitée de façon conservatrice. " 07/01/2022 - "Biochemical abnormalities of liver enzymes are frequently seen in women with PE/E, but outside the spectrum of HELLP syndrome, they are not associated with adverse maternal and fetal outcomes. " 01/01/2019 - "This report represents the criteria for the diagnosis of Abdelazim and AbuFaza elevated liver enzymes, low platelet count (ELLP) syndrome as a variant of HELLP syndrome. " 09/01/2009 - "Postpartum HELLP Syndrome With Unusually High Levels of Liver Enzymes." 01/01/2001 - "There were significant differences in the platelet count, and liver enzymes among the classes of HELLP syndrome. "
2.	Adrenal Cortex Hormones (Corticosteroids)IBA 12/01/2023 - "This study compared the efficacy of corticosteroids in patients with HELLP syndrome, revealing that corticosteroids did not provide any significant benefit in clinical outcomes for pregnant women and newborns with HELLP. " 08/01/1999 - "This study demonstrates that corticosteroids produce a significant improvement in the hematologic abnormalities associated with HELLP syndrome. " 08/01/1999 - "The hematologic abnormalities seen in the 93 patients with HELLP syndrome improved after the administration of corticosteroids. " 01/01/2016 - "The most recent studies definitely recommend the high dose corticosteroid treatment in recovery management by the HELLP syndrome. " 05/01/2013 - "Seeking the mechanism(s) of action for corticosteroids in HELLP syndrome: SMASH study."
3.	Dexamethasone (Maxidex)FDA LinkGeneric 04/01/1999 - "We report a patient with HELLP syndrome in whom antenatal administration of high-dose dexamethasone helped achieve disease stabilization and delivery postponement for 9 days of a very preterm fetus estimated to weight less than 600 g. " 04/01/2019 - "In this retrospective study, we demonstrated that dexamethasone administration significantly improved the recovery of the platelet count in postpartum women with class 1 HELLP syndrome, and did not increase the rate of maternal postpartum complications. " 02/01/2008 - "the present study is a secondary analysis of a randomized clinical trial design to evaluate the efficacy of dexamethasone in patients with HELLP syndrome. " 02/01/2008 - "to describe the clinical and laboratorial profile of HELLP syndrome patients admitted at an Obstetric Intensive Care Unit (ICU) and included in a randomized clinical trial to evaluate the efficacy of dexamethasone in this clinical setting. " 12/01/2006 - "Dexamethasone, HELLP syndrome, and study design."
4.	Transaminases (Aminotransferases)IBA 11/14/2021 - "Because BPH/5 mice develop the maternal and fetal hallmarks of PE during pregnancy, we hypothesized that they may also share the clinicopathologic findings of the human PE-associated hemolysis elevated liver transaminases low platelets (HELLP) syndrome. " 05/01/2020 - "HELLP syndrome is a laboratory diagnosis based on the triad of haemolysis, elevated aminotransferase levels and a platelet count < 100 G/l. " 01/01/2019 - "HELLP syndrome occurred in one patient, which resolved after delivery, and one patient experienced arterial hypertension and elevated transaminase. " 12/01/1992 - "Fatty infiltration did not correlate with the severity of the HELLP syndrome's histologic condition, but, in contrast, did correlate with thrombocytopenia and aminotransferase elevations. " 12/01/1997 - "The study population comprised 14 primigravidae women with class 1 or 2 HELLP syndrome (platelet count < 50,000 or < 100,000/mm3, elevated transaminase levels, evidence of hemolysis) and 17 women with severe preeclampsia (American College of Obstetricians and Gynecologists criteria). "
5.	HaptoglobinsIBA 06/01/1993 - "Administration of haptoglobin and blood purification would be beneficial for patients complicated with HELLP syndrome." 11/01/2000 - "Efficacy of haptoglobin administration in the early postoperative course of patients with a diagnosis of HELLP syndrome." 10/01/2023 - "It was concluded that haptoglobin values could be used together with other biochemical parameters to diagnose HELLP syndrome and predict newborn outcomes." 03/01/2003 - "Haptoglobin and its association with the HELLP syndrome." 01/01/1999 - "The percentage of preeclamptic patients (26.9%) or patients with the HELLP syndrome (73.5%) with elevated GSTP1-1 levels was lower than those with elevated LDH (38.8% and 100%, respectively) or decreased haptoglobin levels (41.8% and 97%, respectively). "
6.	Aspirin (Acetylsalicylic Acid)FDA LinkGeneric 10/29/2010 - "Five pregnancies were uneventful, while HELLP syndrome developed in the mother in which high-dose aspirin was continued till delivery, with rapid improvement after delivery. " 05/01/2023 - "Conclusion Among women who are at high risk of developing preeclampsia, Aspirin 150 mg once a day at bedtime is more effective than Aspirin 75 mg once a day at bedtime in preventing preeclampsia with similar fetomaternal outcomes (NICU admission, IUGR, neonatal death, still birth, eclampsia, HELLP syndrome, placental abruption and pulmonary edema)." 05/01/2003 - "The aspirin (n = 1644) and placebo (n = 1650) groups did not differ significantly in the mothers' incidence of pre-eclampsia (28 of 1632 [1.7%] vs 26 of 1637 [1.6%]; relative risk, RR, 1.08, 95% CI 0.64-1.83), hypertension, HELLP syndrome or placental abruption, or in the children's incidence of perinatal deaths or birthweight below the 10th centile. " 01/01/1990 - "In five cases, temporary reversal of the HELLP syndrome was achieved using low-dose aspirin and corticosteroids. " 08/01/2006 - "In the aspirin group, two pregnancies were terminated: for tricuspid insufficiency and for hemolysis, elevated liver enzymes, low platelet (HELLP) syndrome. "
7.	Dacarbazine (DIC)FDA LinkGeneric 09/01/2022 - "The study population was divided into three groups: (1) comparison group (n = 207,266 deliveries); (2) HELLP syndrome without DIC (n = 320); (3) HELLP syndrome with DIC (n = 21). " 12/31/2022 - "Furthermore, the results suggested the potential role of sENG and the PlGF/sENG ratio in the prediction of adverse outcomes such as HELLP syndrome and DIC." 09/01/2022 - "Objectives: (1) Address the gaps in knowledge regarding the prevalence, epidemiologic and clinical characteristics of women with HELLP syndrome who develop DIC; and (2) determine the risk factors for the development of DIC among women with HELLP syndrome. " 09/01/2022 - "Additionally, until now, there is no adapted and widely accepted way to diagnose DIC among pregnant women presenting with HELLP syndrome, despite the evident maternal mortality linked to the disease. " 09/01/2022 - "There is a lack of information regarding epidemiologic and clinical characteristics of women who developed HELLP syndrome with and without DIC. "
8.	Prednisolone (Predate)FDA LinkGeneric 09/01/2006 - "A randomised placebo-controlled trial of prolonged prednisolone administration to patients with HELLP syndrome remote from term." 01/01/2008 - "Blood samples from patients with HELLP syndrome who were receiving either prednisolone or placebo were obtained before, during, and after a HELLP exacerbation in the antepartum period. " 01/01/2008 - "To investigate the effect of prednisolone on HELLP syndrome by assessing several markers of the inflammatory response and hepatic damage associated with HELLP syndrome. " 01/01/2008 - "HELLP syndrome is associated with an increased inflammatory response, which may be inhibited by administration of prednisolone." 09/01/2006 - "When expectant management is pursued in selected patients with a HELLP syndrome remote from term, prolonged administration of prednisolone reduces the risk of recurrent HELLP syndrome exacerbations."
9.	Inosine Triphosphate (ITP)IBA 09/01/2006 - "However, the adverse outcome is specifically attributed to preeclampsia, HELLP syndrome, and rare causes, while the perinatal outcome of GT and ITP is basically favorable. " 08/18/2021 - "The aim of this study is reporting a complex case of immune thrombocytopenic purpura (ITP) during pregnancy who has been diagnosed with COVID-19 as well as suspicion of HELLP syndrome. " 01/01/2019 - "The causes of this condition are diverse, although the most common etiology is gestational thrombocytopenia (GT) (70%-80%), followed by HELLP syndrome and immune thrombocytopenia (ITP). " 09/01/2008 - "Although there is no risk of maternal or fetal hemorrhage with IGT, a benign disorder, preeclampsia, HELLP syndrome and ITP expose mother and child to potentially life-threatening complications. " 01/01/2006 - "Gestational thrombocytopenia (defined as a mild thrombocytopenia, occurring during the 3 rd trimester with spontaneous resolution postpartum and no neonatal thrombocytopenia) is the most common cause of thrombocytopenia during pregnancy but a low platelet can also be associated with several diseases, either pregnancy specific or not, such as preeclampsia, HELLP syndrome, or idiopathic thrombocytopenic purpura (ITP). "
10.	MagnesiumIBA 05/01/2006 - "[Elevated magnesium levels treated successfully in a woman with pre-eclampsia and HELLP syndrome]." 01/01/1994 - "[Magnesium therapy in preeclampsia and HELLP syndrome--studies of pathophysiology]." 05/02/2023 - "The purpose of this literature review is to investigate the role that magnesium and platelet-activating factors have on clinical hypertension, pre-eclampsia, and HELLP syndrome while focusing on the interplay between these molecules." 12/01/1991 - "Recent reports of clinical management for eclampsia, liver rupture, HELLP syndrome, severe PIH in the second trimester, severe hypertension, and magnesium toxicity are presented." 12/01/2021 - "Hyponatraemia was associated with a significant rate of complications of preeclampsia; acute kidney injury in 34.1%, HELLP syndrome in 17.1%, fetal growth restriction in 36.4%, stillbirth in 2.3%, the use of magnesium sulphate in 44.2%, and postpartum maternal admission to an intensive care unit in 28.7%. "

Therapies and Procedures

1.	Therapeutics 02/20/2023 - "It is controversial whether PE therapy should be used primarily in the management of HELLP syndrome, but early initiation of PE therapy could be effective for severe HELLP syndrome." 12/03/2015 - "This study evaluates the efficacy of CORT therapy to patients with HELLP Syndrome. " 02/08/2021 - "The gold standard therapy for HELLP syndrome is prompt delivery of the fetus. " 03/01/2016 - "Research articles reporting the efficacy of CORT therapy to HELLP syndrome patients were searched in several electronic databases including EMBASE, Google Scholar, Ovid SP, PubMed, and Web of Science. " 01/01/2022 - "TPE needs to be performed within 24 h of the diagnosis postdelivery when the patient is not responsive to the usual therapies, especially in class I HELLP syndrome."
2.	Plasma Exchange 07/01/2017 - "Typically, AFLP and HELLP syndrome improve after delivery of the fetus, whereas plasma exchange is the first-line treatment for pregnancy associated thrombotic microangioathies (P-TMA). " 10/01/2021 - "The aim of this study was to determin the effectiveness of therapeutic plasma exchange (TPE) for treatment of Class-I HELLP syndrome. " 04/01/2005 - "The aim of this study was to investigate the effects of early postpartum use of plasma exchange in patients with HELLP syndrome on outcomes. " 02/20/2023 - "Therapeutic plasma exchange in postpartum HELLP syndrome: a case report." 01/01/2022 - "Therapeutic plasma exchange in HELLP syndrome: A life savior."
3.	Conservative Treatment 12/01/2021 - "Management of HELLP syndrome occurring before 34 weeks of gestation (WG) is still controversial but conservative management may be beneficial in patients with stable HELLP syndrome. " 06/01/2019 - "Conservative management may be beneficial for both mother and newborn in patients with stable HELLP syndrome. " 01/01/2006 - "Current studies show that conservative treatment of patients with HELLP syndrome is safe, without an increase in morbidity and mortality. " 11/01/1999 - "Only very few studies have supported conservative management in patients with signs and symptoms of HELLP syndrome. " 01/01/1997 - "Previous studies have indicated that this conservative management is also possible with the HELLP syndrome, without an increase in maternal morbidity."
4.	Plasmapheresis 08/01/1997 - "The relationship between HELLP syndrome and CAPS is discussed, and possible pathogenetic mechanisms that explain the efficacy of repeated plasmapheresis in this setting are suggested. " 04/01/2019 - "Plasmapheresis-A lifesaving treatment for life threatening HELLP syndrome." 01/01/2018 - "The first case presented with PE/HELLP syndrome and deteriorated postpartum to improve on plasmapheresis. " 01/01/2014 - "Plasmapheresis: Lifesaving treatment in severe cases of HELLP syndrome." 09/01/1999 - "Rarely, patients with refractory HELLP syndrome require plasmapheresis."
5.	Critical Care (Surgical Intensive Care) 02/01/2017 - "The cases of women with HELLP syndrome who delivered at our tertiary center or surrounding hospitals and were admitted to the intensive care between January 2007 and July 2012 were retrospectively analyzed. " 10/01/2012 - "Multiple organ dysfunctions was diagnosed > 70% of all women admitted to intensive care, but was significantly more frequent in patients with HELLP syndrome and HEEH (p = 0.001). " 04/01/2006 - "It is important to suspect this pathology in the preeclamptic patient, especially if she develops HELLP syndrome, in order to establish opportune diagnosis and treatment with a team including the intensive care, surgery and obstetrical staff." 03/02/2006 - "Maternal outcome in HELLP syndrome requiring intensive care management in a Turkish hospital." 03/01/2006 - "[Intensive care management of HELLP syndrome in Dakar]."