Wednesday, July 18, 2018

Have You Ever Heard Of HELLP Syndrome?

Credit: Miranda Sherman
My Little Girl in the NICU

A severe pregnancy complication that is often misdiagnosed.

As you all know I am a Mom, a stay at home, busy Mom. Some of you know that I have 4 children, very few of you know my daughter Marissa was a preemie. She was born at 28 weeks gestation weighing in at a mere 2 pounds 5 ounces and 15 inches long.

Our story and experience is a pretty intense story. I would love to share the story with you. I was eighteen when I found out I was expecting a baby. The Dr. said I was due the end of September. I was pretty nervous but I knew it would all work out.

When I was about 6 months pregnant I started feeling miserable. When I went to my OB appointments I would tell her my aches and pains. I was having severe backaches and mind splitting migraines. My OB explained to me that this was typical during pregnancy. I accepted her answer and went about my day. What would I know, she's the Dr.

As the weeks wore on I was getting worse. I thought to myself this can't possibly be normal, women wouldn't keep having babies if this was normal. My doctor kept telling me that this was normal and to just take it easy. I was directed to take warm relaxing baths, use a heating pad and take plenty of naps. I followed her orders and there was still no relief. I was very frustrated and felt like no one would listen to me.

One night around 11:00pm I was in such excruciating pain I decided to go to the ER. As I walked into the birthing center everyone was real polite. I had to put on the gown, and belly sleeve, hooked up to a monitor and given a full exam. I was nervous and in a lot of pain. I had to give a urine sample. I was starting to think that whatever was wrong would be taken care of and I would start to feel better. At about 2:30am the doctor came in and prescribed a pain reliever. I thought to myself YAY! About time, I was finally going to be feeling better. Little did I know it was only just beginning!

After a week I had run out of medication and was still in a lot of pain, it had not made any difference. I made an appointment with my OB. While I was there I was given the normal exam, urine, blood pressure etc. I explained everything all over again, all my pains, aches and the whole situation. My OB signed me up for physical therapy for pregnant women. I asked if this was normal, and she replied yes, the reason for the back pain is because my back is not used to supporting all the weight of the baby. I accepted her answer and thought to myself that this can't be right. Something is wrong! No one is listening to me! when I told her this and expressed my feelings I was given this long drawn out explanation and lecture all boiling down to a lot of crap, in the end I left feeling like she had basically told me to shut up, suck it up, quit acting like a wimp! I was FED UP! Even my friends and family were beginning to think that I was a wimp and that I was over exaggerating things. As I was riding the bus home from the clinic, things took a turn for the worse. I was in pain, a lot of pain! I felt like I was going into labor.

When I got home I fell on the couch crying, so frustrated that I was going through this and no one was here to listen or help! I knew something was wrong and I was backed against the wall with nowhere to go. I felt so alone and scared! My friend brought me to my room and calmed me down. At about 5:30pm my cousins came to visit. She gave me an amazing back massage and I felt a lot better! The pain was gone; I was relaxed it was very comforting. Feeling so good, I decided to take a nap. When I woke up the pain was back. My friend asked if I wanted to take a bath, nope, not me, I was way to sore to even move. The Dr. had said if the pain gets bad, lay down, put my feet up and take a nap. My friends had suggested this and to see how I felt later. Nope, I was sick of this, I needed to go NOW!! I was on a mission! I was going back to the hospital and I wasn't leaving until they figured something out!

I got a ride to the hospital. My friend decided to stay home, seriously, people were really beginning to think I was full of it and it was all in my head, no one came with me, I got a ride to the hospital and was left after I checked in. As I walked into the birthing center all the staff had the look of "oh great, it's her again, the baby is back" I was infuriated! They did the same procedure as last time, urine, monitors, blood pressure cuff, and another exam. Then I noticed things started to get a little weird. This time lab came and did a blood draw. I just figured maybe they were going to try testing for something else.

Then nurses and doctors started moving a little faster, people were popping in and out constantly checking different things, nurses were sweating, and moving fast. No one could answer any of my questions or explain what was going on. I was starting to get very stressed out! When the nurses came in to hook up an IV, I knew something was wrong, something was happening and I needed answers! It took 5 or 6 tries, lost count after 4, if you've had an IV you know, this is not pleasant at all, pretty painful, especially if you are poked over and over. Then the nurse told me to call home. I told her it was OK, I could tell them everything later or tomorrow when I get home. Then she looked at me and very rudely and harsh she said, "Call them NOW, you are going to have the baby!" I kept saying over and over, "it's too early, I'm not due yet" I called my friends and family and told them to come to the hospital, I was having the baby! As I said the words, I started to bawl my eyes out!

I was so frustrated that all this time I had been telling them that something was wrong and nobody would listen to me. When he got there things took a turn for the worse. He was sitting next to me trying to calm me down. I said I was nauseous. I told the nurse and she handed me a puke pan, I set it aside, I felt like this my whole pregnancy and I never threw up. All of a sudden I started vomiting, and it was bad! It was very forceful and projectile, I felt like I should have been filming the exorcism (I know gruesome but hey, it happened) The nurses suddenly pushed everyone to the side. All of a sudden I was in a surgical room. I still had NO CLUE what was going on and what was wrong with me.

12:16am July 2000, I gave birth by emergency c-section to a tiny daughter, Marissa. She weighed in at 2lbs. 5oz and a small 15 inches long. I had only been 28 weeks along when my little girl was born. She was immediately taken to the NICU. After the surgery I was given 1 blood transfusion and 2 platelet transfusions. It turns out I almost died. My OB said if I would have lied back down and took another nap, I probably would not be here today. I was told my body had shut down and I had gone into shock, which caused the vomiting and incoherence. Out of this whole experience I have learned two things.

1. Always trust your instinct no matter what anyone says

2. I truly do have a miracle baby, a real gift from God!

Now that you have read all this, I am sure you are wondering what the heck is HELLP Syndrome? HELLP Syndrome is the medical term for one of the most serious complications of pre-eclampsia, in which there is a combined liver and blood clotting disorder.

H- stands for hemolysis, breaking down of red blood cells

EL- stands for elevated liver enzymes in the blood, causing liver damage

LP- stands for low platelet count, needed for blood clotting

Hellp Syndrome is life threatening. Sometimes misdiagnosed as gastritis, acute hepatitis, disseminated intravascular coagulation(DIC), gall bladder disease. As a result, the mother does not receive the right treatment.

When it comes to diagnosing HELLP syndrome a platelet count appears to be the most reliable indicator of the presence of HELLP syndrome. The syndrome has been considered a variant of pre-eclampsia, but it can occur on its own or in association with pre-eclampsia. Pregnancy-induced hypertension, pre-eclampsia and HELLP syndrome are related and overlap in their presentations.

Symptoms for HELLP Syndrome are as follows,
1. High Blood Pressure
2. Protein in Urine
3. Swelling in face, feet and hands
4. Pain below the ribs known as epigastric pain
5. Severe headache
6. Vomiting or feeling of nausea
7. Feeling tired
8. Visual disturbances
9. Bleeding
If you notice any of these symptoms, Notify your doctor immediately.
Not all symptoms have to be present but these are the symptoms that are most often reported.

The most common reasons for the death of the mother are liver rupture or stroke. These can be prevented if it's caught in time! If you or someone you know has any of these symptoms, please see a doctor immediately!
The only known treatment for women with HELLP Syndrome is delivery, regardless of how far along in the pregnancy the mother is.

They do not know the cause of HELLP Syndrome. Any pregnant woman can get this illness.

- 5 to 7% of all pregnant in the U.S develop pre-eclampsia.
- Between 2 and 12% go on to suffer from HELLP Syndrome.
- Estimates are that HELLP Syndrome occurs in 1 per 150 live births, with a mortality rate of 3.50% .

New Information shows because no cause for HELLP syndrome is yet known, doctors aren't able to pinpoint who will develop the condition. It seems that any pregnant woman is at risk for developing HELLP syndrome, though there are a few factors that may increase your risk. These include:

* being under 20 or over 35
* being pregnant for the first time
* having high blood pressure, pre-eclampsia, or eclampsia during your pregnancy
* having HELLP syndrome, pre-eclampsia, or eclampsia during a previous pregnancy

Does HELLP Syndrome affect the baby? Most common is small for Gestational age/ low birth weight. At birth baby may be over sedated due to medications of both mother and child. Child may have Hypermagnesemia due to magnesium sulfate treatments given to the mother. Surfactant is usually given to the mother which will help babys lungs mature at a faster rate. Other than that the baby is usually given morphine or other relaxers so the baby does not pull out any tubes and such.

Can you get HELLP Syndrome again? HELLP Syndrome has a 29% chance of re-occurrence. Studies show you are more likely (50%) to have some other pregnancy complication including but not limited to:

preterm labor
heavy weight gain
high blood pressure
severe morning sickness.

When I was expecting my second child, the Dr. had me do the following to ease things along:

1. I made sure my Ob was aware of my past
2. Made sure my Ob has dealt with HELLP before
3. Have my weight, blood pressure and urine checked each visit
4. Made sure they will be watching my platelet levels
5. Talked with the doctor about preventive measures she then has me on a higher dose of pre-natal vitamins and a low dose 80mg children enteric aspirin once a day called aspirin therapy.

There is not a lot of information out there about HELLP Syndrome and how serious it is. They do not write about it in the pregnancy books, or magazines. I have done a lot of research on HELLP and have talked to a lot of women who have had HELLP and have heard a lot of stories. Because this story and experience has had a major role in who I am today and the bond I have with my daughter I felt I should share my story with you. I am also sharing some of the photos that were taken of my princess in the NICU. If you have any questions feel free to ask, my goal has always been to share information and educate people. Feel free to share our story with others, the more people that have this information the better! Thank You for listening and thanks for you're support!


About the Writer

Miranda is a writer for BrooWaha. For more information, visit the writer's website.
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1 comments on Have You Ever Heard Of HELLP Syndrome?

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By Angie Alaniz on October 26, 2011 at 10:15 am

Gosh that is some story!

You really do have special gift from God, and I am thankful that you shared your story with us. Your picture is very touching.

I hope tons of OB doctors read this article so they can learn something from this experience. Which I believe the most Important lesson here is to "listen" to your patients more carefully.

And I now know what HELLP Syndrome is.

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