Syndrome help (HELLP-syndrome) is a dangerous complication in the third trimester of pregnancy: causes, diagnosis, treatment
In life every person inevitably comes a time that compels to turn to outside help. Often helpers in such situations are the health care providers. This occurs if the human body occupied an insidious disease, and to cope with them is not possible. Everyone knows that a happy state of pregnancy is not a disease, but it is the future moms especially need medical and psychological assistance.
Help me! or Where the name of the disease
The call for help in different languages sounds different. For example, in English Russian a desperate "Help!" is pronounced as "help". Syndrome help (HELLP) it is no coincidence that almost in tune with has already become an international plea for help.
The symptoms and consequences of this complication in pregnancy is such that urgent medical intervention is essential. The acronym HELLP stands for a whole range of health problems: in the liver, with blood clotting and an increased risk of bleeding. In addition, HELLP syndrome can cause malfunctions in functioning of the kidneys and disorders of the blood pressure, thereby greatly aggravating the course of pregnancy.
The picture of the disease is so severe that the denial of the body of the fact of procreation, comes autoimmune failure. This situation occurs when total congestion of the female body when the protective mechanisms fail to work, causing severe depression, disappears the will to life's challenges and continue the struggle. The blood does not clot, the wound will not heal, bleeding has not stopped, and the liver is not able to perform its functions. But this is a critical condition amenable to medical correction.
Syndrome help was described in the late 19th century. But only in 1978 Hudlin tied this autoimmune pathology with preeclampsia during pregnancy. And in 1985, thanks to Weinstein, odd symptoms were combined under one name: HELLP syndrome. It is noteworthy that in the domestic medical sources, this is a serious problem practically is not described. Only some Russian anesthesiologists and specialists in providing intensive care for more detailed analysis of this serious complication of preeclampsia.
Meanwhile, help syndrome in pregnancy is rapidly gaining momentum and takes many lives.
Describe each complication separately.
Syndrome help first involves intravascular hemolysis. This severe disease is characterized by total cell destruction. The destruction and aging of red blood cells causes fever, yellowness of the skin, appearance of blood in urine studies. The most life-threatening consequences – the risk of heavy bleeding.
The risk of thrombocytopenia
The following component abbreviations of the syndrome is thrombocytopenia. This condition is characterized by reduction of platelets in the blood, eventually causing spontaneous bleeding. To stop such a process can only be in the hospital, and during pregnancy this condition represent special danger. The reason can be harsh immune disturbances resulting in the anomaly in which the body fights with itself, destroying healthy blood cells. Threat to life is encountered at the background of changes in the number of platelets in the clotting of blood.
Terrible harbinger: increased liver enzymes
The range of pathologies included in the syndrome help, is crowned by a bad sign, as an increase in liver enzymes. For mothers this means that in one of the most important organs of the human body serious disruptions. Because the liver not only cleanses the body from toxins and helps support digestive function, but also affects the psycho-emotional sphere. Often, this undesirable change is detected during routine blood test, which is administered to a pregnant woman. When preeclampsia complicated by syndrome help, the indicators are significantly different from the norm, revealing a threatening picture. Therefore, medical consultation is the first procedure that are binding.
Particularly the third trimester
3 trimester of pregnancy is very important for the further gestation and delivery. Common complications are swelling, heartburn and digestive dysfunction.
This occurs due to disorders in the kidneys and liver. The enlarged uterus exerts a lot of pressure on the digestive organs, causing them to begin to fail. But preeclampsia can occur the condition called preeclampsia and eclampsia, which exacerbate pain in the epigastric region, provoke nausea, vomiting, edema, high blood pressure. On the background of neurological complications can occur seizures. The dangerous symptoms increase, sometimes at lightning speed, causing great harm to the body, threatening the life of the expectant mother and the fetus. Because of severe preeclampsia, which often carries with it the 3 trimester of pregnancy, there is often a syndrome with the telling title help.
HELLP syndrome: clinical picture, diagnosis, obstetric tactics is the topic of conversation. First, you need to designate a number of the main symptoms that accompany this serious complication.
- CNS. The nervous system responds to data breach cramps, intense headaches, visual disturbance.
- The cardiovascular system is disrupted due to swelling of tissues and reduced blood circulation.
- Respiratory processes mostly are not violated, however, after birth, can occur in pulmonary edema.
- From the notes of hemostasis thrombocytopenia and violation of the functional component of the work of the platelets.
- The decrease in liver function, sometimes the death of its cells. Rare spontaneous rupture of the liver, which leads to death.
- Disruption of the urogenital system: oliguria, renal dysfunction.
Syndrome help different variety of symptoms:
- unpleasant sensations in the liver area
- acute headaches
- a violation of consciousness
- insufficiency of urination
- the swelling of tissues
- irregular pressure
- multiple hemorrhages in venues of manipulation
- a yellowness.
Laboratory the disease is manifested by thrombocytopenia, hematuria, detection of protein in urine and blood, low hemoglobin, increased bilirubin in the blood. So to clarify the final diagnosis it is necessary to carry out the full range of laboratory tests.
Time to recognize complications?
In order to detect and prevent serious complications, and carried out medical consultation that future mothers are encouraged to come regularly. Specialist pregnant puts on the account, after which closely tracked the changes in a woman's body during the entire period. Thus, the gynecologist in a timely manner will fix unwanted changes and take appropriate action.
Identify pathological changes by using laboratory tests. For example, urinalysis can detect protein, if any. Increase the protein indicators and the number of cells of said distinct disorders in the kidneys. Additionally, you may experience a sharp decrease in the amount of urine and a significant increase in edema.
Problems in the liver manifested not only by pain in the right hypochondrium, vomiting, but also changes in the blood composition (increase in the number of hepatic enzymes), and palpation clearly there is enlargement of the liver.
Thrombocytopenia can also be found in a laboratory study the blood of a pregnant woman for whom a real threat of syndrome help.
If you suspect the occurrence of eclampsia and help syndrome mandatory control of blood pressure, as due to spasm of blood vessels and thickening of the blood, its performance can seriously increase.
Fashionable now the diagnosis of khelp-syndrome in obstetrics has gained popularity, so they often put it wrong. Often it hides absolutely other diseases equally dangerous but more mundane and common:
Therefore, the dif. diagnosis needs to consider a variety of options. Accordingly, the above-mentioned triad — hyperfermentemia of the liver, hemolysis and thrombocytopenia does not always indicate the presence of this complication.
The causes of help syndrome
Unfortunately, risk factors are not well understood, but there are suggestions that trigger the syndrome. can help the following causes:
- psychosomatic pathology
- drug-induced hepatitis
- genetic enzymatic changes in the liver
- the multiple pregnancy.
In General, a dangerous syndrome occurs when the lack of attention to complicated for preeclampsia — eclampsia. It is important to know that the disease behaves very unpredictable: it is developing at lightning speed, then disappears on its own.
When carried out all the tests and the WPPT. diagnosis, it is possible to draw certain conclusions. When the diagnosis "help syndrome" treatment is aimed at stabilizing the pregnant woman and the unborn child, as well as a speedy delivery regardless of the term. Medical activities are carried out with the help of an obstetrician-gynecologist, intensive care team and anesthesiologist. If necessary, connect other professionals: a neurologist or ophthalmologist. First eliminates multiple organ failure, and provides preventive measures to avoid possible complications.
Among the common phenomena, complicating the course of a medical intervention, can be identified:
- placental abruption
- swelling of the brain
- pulmonary edema
- acute renal failure
- fatal changes and the rupture of the liver
- uncontrollable bleeding.
With the correct diagnosis and timely professional help the likelihood of a complicated course seeks to a minimum.
Tactics practised obstetrics in relation to the severe forms of preeclampsia, the more complicated syndrome help, is unambiguous: the Caesarian. When Mature the uterus, ready for a natural childbirth, use of prostaglandins and required an epidural.
In severe cases, when the cesarean section is used exclusively endotracheal anesthesia.
Life after birth
The experts pointed out that the disease occurs during the third trimester, but can progress to two days after getting rid of the burden.
So help syndrome after giving birth — a phenomenon quite possible that speaks in favor of close observation of mother and child in the postpartum period. This is especially true of women with severe preeclampsia during pregnancy.
Who is to blame and what to do?
Syndrome help is the malfunction of almost all organs and systems of the female body. During disease there is an intensive outflow of vitality, and high probability of death and foetal abnormalities of the fetus. Therefore, since the 20th week the expectant mother must keep a diary of self-control where to log all the changes that occur in the body. Special attention should be paid to the following points:
- blood pressure: it jumps upward more than three times should be cause for concern
- metamorphosis weight: if it has been dramatically increasing, perhaps because of swelling
- fetal movement: too intense, or, conversely, the frozen movement is a definite reason for seeking medical attention
- the presence of swelling: significant swelling of tissues tells about renal dysfunction
- unusual abdominal pain: especially significant in the liver
- regular tests: all assigned, you must perform faithfully and on time, as it is necessary for the good of the mother and the unborn child.
All the alarming symptoms should immediately inform your doctor because only a gynecologist can adequately assess the situation and make the right decision.