Preeclampsia, Eclampsia,

and HELLP Syndrome

Siera Stokes (and other students)
Objectives- Preeclampsia, Eclampsia, HELLP
● Learn what it is
● Signs and symptoms
● Risk factors
● Diagnostic tests
● Treatment and Management
● Prevention
Gestational HTN: WHat is it?
- High blood pressure (140/90 mmHg) that occurs in the second half (post 20
weeks) of pregnancy
- Usually goes away after childbirth, it may increase the risk of developing
hypertension in the future
Gestational HTN: Key Problems
-Places extra stress on the patient's heart and kidneys, leading to increased risk for cardiac disease, renal disease and stroke

-Other complications:

-Fetal growth restriction

-HTN decreases flow of nutrients and O2, could result in a preterm delivery

-Preeclampsia

-Placenta abruption- premature detachment from uterine wall

-C Section
Preeclampsia: What is it?
-High blood pressure in addition to other signs:

-Proteinuria

-Low platelets

-Abnormal kidney and liver function

-Upper abdominal pain

-Vision changes

-Fluid in lungs

-Sever Headache
Preeclampsia: When does it occur?
- After 20 weeks
- Typically third trimester
- When it occurs before 32 weeks it is termed: early-onset preeclampsia
- Can also occur in the postpartum period
Signs & Symptoms - Severe Preeclampsia
MOM BABY
● Elevated BP ● Slowed growth
● Headache ● Decreased amount of amniotic
● Change in vision: blurry vision, fluid
flashes of light, spots
● Upper belly pain
● Proteinuria
● Edema in hands and face

Most women do not show signs unless it is severe preeclampsia.

 Diagnostic tests for Preeclampsia
● Urinalysis (looking for proteinuria 1+ or more)
● Blood test (liver function test showing damage, kidney function test showing
damage,low platelet count)
● CBC (Increased hematocrit, decreased RBC)
● Blood pressure (higher than 140/90) Severe preeclampsia is characterized by
blood pressure over 180/110 on two occasions at least 6 hours apart while on
bedrest.
Treatment/Management preeclampsia
● Delivery remains the ultimate treatment- gestational age
and indications evaluated (if the baby is developed enough,
physician will most likely want to deliver).
● If baby is not close to full development the mother is
instructed to-
○ Rest, lying on left side to take the weight of the baby
off major blood vessels
○ Increase prenatal checkups
○ Consume less salt
○ Drink at least 8 glasses of water a day
○ Change diet to include more protein
● If preeclampsia is severe, the mother may be treated with
hypertension drugs
Prevention- Preeclampsia
● Maintain a healthy weight throughout pregnancy
● Eat a healthy and balanced diet, including more protein
● Use little or no added salt
● Exercise regularly
● Elevate your feet when possible throughout the day
● Get enough rest
● Drink 6-8 glass of water daily
● Avoid fried foods
● Avoid drinking alcohol
● Avoid caffeine
● Do not miss regularly check-ups with your doctor, check-ups may need to become more frequent
● Lay on your left side to relieve pressure on major blood vessels
Eclampsia-what is it?
-A woman is usually diagnosed with preeclampsia before eclampsia.

-The pre-eclampsia progresses to full blown eclampsia which has all the characteristics
of pre-eclampsia but with the presence of seizures. The seizures can lead to coma.

-Can also occur postpartum

Signs and Symptoms - Eclampsia
MOM BABY
● Signs of Preeclampsia ● Small or premature baby
● Tonic-Clonic Seizure
● Altered mental status
● Tachypnea
● Anxiety
● Wheezing
 Diagnostic tests for eclampsia
● Urinalysis (proteinuria 3+ or more)
● Blood pressure (over 180/110)
● Blood tests: (CBC, H+H-anemia,increased bilirubin, thrombocytopenia, creatinine
is elevated, reduced GFR)
● Liver function test (showing liver injury)
● CT scan (for seizures)
Mom Risk Factors: Preeclampsia-eclampsia
● High BMI
● Previous pregnancy with preeclampsia
● Preexisting conditions
○ HTN
○ Renal Disease
○ Thrombophilias
○ Diabetes
○ Collagen Vascular Disease
● Nulliparity
● African American
● Family HX
treatment /management of eclampsia
● Again, the only cure is delivering the fetus
● Magnesium sulfate is used for prevention of eclamptic seizures in women with severe preeclampsia and
for treatment of women with eclamptic seizures
● Magnesium sulfate has been shown to be superior to phenytoin (Dilantin) and diazepam (Valium) for the
treatment of eclamptic seizures.
● Antihypertensive drugs are also recommended to lower BP- Hydralazine, Labetalol
Prevention- eclampsia
● Maintain a healthy weight throughout pregnancy
● Eat a healthy and balanced diet
● Use little or no added salt
● Exercise regularly
● Elevate your feet when possible throughout the day
● Get enough rest
● Drink 6-8 glass of water daily
● Avoid fried foods
● Avoid drinking alcohol
● Avoid caffeine
● Do not miss regularly check-ups with your doctor.
HELLP- What is it?
● HELLP is a syndrome including high blood pressure during pregnancy
● It is life threatening and is a variant of preeclampsia
● It includes Hemolysis, elevated liver enzymes and low platelet count
Signs and Symptoms - HELLP Syndrome
MOM BABY
● Signs of preeclampsia/eclampsia ● Small preterm baby
● Belly pain ● Malnourished
● Nausea and vomiting
 Diagnostic tests for HELLP Syndrome
H- hemolysis (abnormal peripheral smear and anemia)

EL- elevated liver enzymes (AST 2x more than normal)

LP- low platelet count (less than 100,000) *As soon as this drops in pregnant
woman-suspect HELLP

“Hemolysis, Elevated liver enzymes, and low platelet count”

Mom Risk Factor: HELLP syndrome
● Multiparous
● Maternal age >25 years
● Caucasian
● Overweight
● Poor Diet
● Previous pregnancy with preeclampsia
Effects on fetus/baby
● Utero-placental insufficiency > growth issues
● Preterm birth
● Increased Risk
○ Deafness
○ Blindness
○ Cerebral Palsy
○ Epilepsy
○ Learning Disorders
○ Diabetes
○ Congestive Heart Failure
○ HTN
● Stillbirth
Treatment/Management of hellp syndrome
● Delivery of the fetus
● Hospitalization to provide IV meds to control BP, and prevent seizures and complications
● The mother may also receive steroid injections to speed up the development of the fetus’s lungs.
● During pregnancy, many women suffering from HELLP syndrome require a transfusion of some
form of blood product (red cells, platelets, plasma)
Prevention- HELLP syndrome
● There is no proven cause for HELLP Syndrome, so doctors and researchers are
unsure how to prevent it.
● Main ideas are to:
○ Eat a balanced diet
○ Exercise regularly
○ Drink 6-8 glasses of water daily
Reference Page
Lippincott Advisor for Education. (2016). Lippincott Advisor for Education. Retrieved February 26, 2017, from
http://advisor-edu.lww.com/lna/home.do

What are the risks of preeclampsia & eclampsia to the fetus? (n.d.). Retrieved September 17, 2017, from
https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/Pages/risk-fetus.aspx#citationsconten

Preeclampsia: Symptoms, treatment, and prevention. (2017, April 4). Retrieved September 17, 2017, from American
Pregnancy Association website:http://americanpregnancy.org/pregnancy-complications/preeclampsia/

American Pregnancy Association (2017). Preeclampsia. Retrieved September 22, 2017 from
http://americanpregnancy.org/pregnancy-complications/preeclampsia/

Wagner, LK (2004). Diagnosis and Management of Preeclampsia. American Family Physician. Retrieved September 22, 2017 from
http://www.aafp.org/afp/2004/1215/p2317.html.