Hellp Syndrome

  1. What is the prognosis for someone with HELLP Syndrome?A teenager is on our ICU with it. She had a c-section and then they immediately sent her to ICU. Now she is intubated and has been unresponsive for almost 2 weeks and swollen up like the Michelin man. I also think she went into D.I.C. She seems more stable now. IS there any chance of her pulling through? This is the first time I have seen this and it is very disturbing to me. Maybe because she is so young. I am used to dealing with older people. As a student I am just curious.
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  2. 12 Comments

  3. by   fergus51
    Unfortunately, the prognosis depends on how much damage had already been done to her before the baby was delivered. I have never had a patient get that far, mainly because of good prenatal care, so I can't really say how this woman would do.
  4. by   SmilingBluEyes
    Yes, there is a chance of her pulling through. Without doubt, she is ONE SICK LADY and it DOES sound as if she did go into DIC, which makes it even more critical. I cannot even begin to quote statistics of survival rates; I would not try. I don't know the history or her whole course. It is disturbing, tragic,and yes, people DO DIE of these complications. If you are a praying person, I would say this is a very appropriate time to do so; I feel divine intervention often comes into play in the recovery of such patients. But then, that is a personal belief. Pls let us know how she does. I am VERY interested! sorry i was not much help here.
  5. by   psychomachia
    Try this site: Thrombocytopenia in Pregnancy

    It lists the maternal mortality at 1% for HELLP. Also, the article points out that not all patients develop the entire syndrome (Hemolysis, Elevated Liver Enzymes, Low Platelets), but if she also has developed DIC, I would think that her condition was/is fairly severe.

    For the patient this is a horrible thing to have happen, but as a student it would make a great learning experience. I would ask the ICU nurse what her lab values are and what treatment has been done and/or is planned. Seeing a patient with the disease helps to understand all the "book work" that you have to put yourself through while in school.
  6. by   imenid37
    wow i am so sorry to hear about your pt. i think she does have a chance to pull through, but it depends on what kind of organ damage (renal, brain, hepatic) she may have sufferred. who is managing her care? often times perinatology and medicine co-manage these pts. the hellp syndrome society is an organization that is there mostly to support pts. who have had hellp and their families. try a google search for them and you may get some useful info. there is an excellent article by judy poole i pulled of of the aacn web site i think last year under ceu's on hellp. try this link http://www.aacn.org/AACN/jrnlci.nsf/...4?OpenDocument . i hope your pt pulls through. this is very sad for her and her family as well as her caregivers.
  7. by   HazeK
    none of our HELLP patients have ever progressed to ventilators...
    makes me wonder if she has deterioated to Fatty Liver Syndrome...
    which is much worse, higher mortality rate & often associated w/ DIC.

    Very hard to 'loose' our mommies!

    Hugs!
    Haze
  8. by   Flo1216
    The girl actually had prenatal care throughout the entire pregnancy. From what I heard, she hadn't been feeling well right before it happened and she went to to the doctor and she was treated for a UTI. Everyone is real hush-hush about it too, which is unusual in my hospital. I am starting to think that perhaps something was overlooked in this girl before all of this happened. I also read that HELLP is often misdiagnosed. I saw her yesterday and her BP was over 200, she was jaundiced, black and blue and swollen. I saw a picture of her and it doesn't even look like the same girl. The girl in the picture was young, thin, beautiful and happy. It is so hard for her family to see her like this because she looks like someone else. From what I understand, however, the baby is doing well and was just extubated. I can't stop thinking about her. I don't know why. I hope she makes it.
  9. by   Flo1216
    The girl actually had prenatal care throughout the entire pregnancy. From what I heard, she hadn't been feeling well right before it happened and she went to to the doctor and she was treated for a UTI. Everyone is real hush-hush about it too, which is unusual in my hospital. I am starting to think that perhaps something was overlooked in this girl before all of this happened. I also read that HELLP is often misdiagnosed. I saw her yesterday and her BP was over 200, she was jaundiced, black and blue and swollen. I saw a picture of her and it doesn't even look like the same girl. The girl in the picture was young, thin, beautiful and happy. It is so hard for her family to see her like this because she looks like someone else. From what I understand, however, the baby is doing well and was just extubated. I can't stop thinking about her. I don't know why. I hope she makes it.
  10. by   Flo1216
    The girl actually had prenatal care throughout the entire pregnancy. From what I heard, she hadn't been feeling well right before it happened and she went to to the doctor and she was treated for a UTI. Everyone is real hush-hush about it too, which is unusual in my hospital. I am starting to think that perhaps something was overlooked in this girl before all of this happened. I also read that HELLP is often misdiagnosed. I saw her yesterday and her BP was over 200, she was jaundiced, black and blue and swollen. I saw a picture of her and it doesn't even look like the same girl. The girl in the picture was young, thin, beautiful and happy. It is so hard for her family to see her like this because she looks like someone else. From what I understand, however, the baby is doing well and was just extubated. I can't stop thinking about her. I don't know why. I hope she makes it.
  11. by   Flo1216
    What is fatty liver syndrome?
  12. by   imenid37
    so bizarre. i just returned from work. one of our pt's has hellp vs. acute fatty liver.
  13. by   L&D.RN
    One of the L&D nurses I work with just went through HELLP with her daughter...the daughter had passed out an he had found her in the bathroom and would be meeting them at the ER. By the time my coworker got to the ER, her daughter was posturing. The ER docs thought menengitis. Finally after a few hours, my coworker asked them if they'd thought about HELLP . . . that's what it was, and then DIC, and she was in the hospital quite some time, and intubated...at first couldn't talk or remember very well, but has since gained back almost everything. Her baby, which was 26 weeks, is doing well too. So there is a chance.
  14. by   mother/babyRN
    So sad. One of the nurses working with me had a severe case. She delivered twins and her platelets went down to 30 and her liver was terrifically enlarged and in danger of rupture. It was touch and go for awhile but she pulled through after receiving IV decadron.....Took awhile and she was critical for a bit..

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