Question

Define, Risk factor, patho, sign and symptoms; What do we went to prevent? Nursing management; Asess, Do Treatments, medication for HELLP Syndrome

Answer 1

DEFINITION: HELLP syndrome stands for hemolysis, elevated liver enzymes, and a low platelet count. It is complication of pregnancy and starts in during the last three months of pregnancy or shortly after childbirth.

SIGNS AND SYMPTOMS: fatigue, retaining fluid, headache, nausea, upper right abdominal pain, blurry vision, nosebleeds, and seizures.

RISK FACTORS: It is often associated with eclempsia and pre eclempsia. females older than 25 years, related to female having HELPP syndrome, high BMI, antiphospholipid antibody syndrome, metaboloc disorders.

PATHOPHYSIOLOGY: endothelial cell injury is seen which is followed by vasospasms and platelet activation. Decreased release of the endothelium-derived relaxing factor and increased release of von Willebrand factor(vWF) is seen. This cause activation of the coagulation cascade and inflammation. Placental components like inflammatory cytokines and syncytiotrophoblast particles interact with the maternal immune system and endothelial cells, further enhancing coagulation and inflammation.

Von Willebrand factor degradation in HELLP syndrome is inhibited because of decreased levels of degrading proteins causing increased exposure of platelets to vWF developing thrombotic microangiopathies and lead to thrombocytopenia.

Due to hemolysis, lactic acid dehydrogenase (LDH) and hemoglobin are released, with the latter binding to serum bilirubin or haptoglobin.

endothelial dysfunction leads to hepatocellular damage. This causes liver failure often leading to liver necrosis, haemorrhages, and capsular rupture.

TREATMENT: delivering the baby as soon as possible, corticosteroids to manage BP, blood transfusion.

COMPLICATIONS: disseminated intravascular coagulation(DIC), placental abruption, and acute renal failure, liver failure, still birth and infant mortality.

PREVENTION: since there is no known cause prevention cannot be identified. Healthy diet, exercise and controlled BP is recommended.