HELLP Syndrome: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats HELLP Syndrome?
An obstetrician-gynecologist (ob-gyn), a doctor who cares for women during pregnancy and childbirth, treats HELLP syndrome. It is a medical emergency, so care takes place in a hospital. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is HELLP syndrome?
HELLP syndrome is a group of symptoms that occur in pregnant women. The name stands for hemolysis (the breakdown of red blood cells), elevated liver enzymes, and low platelet count. It damages red blood cells and interferes with blood clotting.
It is considered a variant of preeclampsia, a pregnancy disorder with high blood pressure and other signs of organ injury. HELLP syndrome is a medical emergency, and women can die from it. It occurs in about 1 to 2 out of 1,000 pregnancies.
Most often, HELLP develops in the third trimester of pregnancy. Sometimes it develops in the week after the baby is born.
Symptoms
Symptoms include:
- Fatigue or feeling unwell.
- Fluid retention and extra weight gain.
- Headache.
- Nausea and vomiting that keeps getting worse.
- Pain in the upper right or middle part of the belly.
- Blurry vision.
- Nosebleed or other bleeding that will not stop easily (rare).
- Seizures, also called convulsions (rare).
Some women bruise easily. HELLP syndrome can happen without high blood pressure or protein in the urine. Sometimes HELLP symptoms are the first warning of preeclampsia.
HELLP syndrome is sometimes mistaken for the flu or another viral illness, gallbladder disease, hepatitis, or a lupus flare.
It can cause problems before and after the baby is born. These include a clotting disorder that leads to too much bleeding, fluid in the lungs, kidney failure, and liver bleeding and failure. The placenta can pull away from the wall of the uterus. Seizures and stroke can also happen. The baby may grow more slowly.
Causes and who gets it
The cause of HELLP syndrome has not been found. Sometimes it is due to an underlying disease, such as antiphospholipid antibody syndrome.
Many women have high blood pressure and are diagnosed with preeclampsia before HELLP syndrome starts. Risk factors include:
- Age greater than 35.
- Obesity.
- A history of preeclampsia.
- A history of diabetes or kidney disease.
- A history of multiple births.
- A history of high blood pressure.
How doctors diagnose it
During a physical exam, the doctor may find belly tenderness on the upper right side, an enlarged liver, high blood pressure, and swelling in the legs.
Liver function tests may show high liver enzymes. Platelet counts may be low. A CT scan may show bleeding into the liver. Protein may be found in the urine. Tests of the baby's health, such as a fetal non-stress test and an ultrasound, are also done.
Treatment
The main treatment is to deliver the baby as soon as possible, even if the baby is premature. Liver problems and other complications can quickly get worse and harm both the mother and the baby.
Your provider may start labor with medicines or do a C-section, which is birth through a cut in the belly. You may also receive:
- A blood transfusion if bleeding problems become severe.
- Corticosteroid medicines to help the baby's lungs develop faster.
- Medicines to treat high blood pressure.
- Magnesium sulfate through a vein, to prevent seizures.
After the baby is born, HELLP syndrome goes away in most cases in 2 to 3 days. Outcomes are most often good if the problem is diagnosed early.
When to see a doctor
Call 911 or the local emergency number if you have symptoms of HELLP syndrome during pregnancy. Examples are pain in the upper right or middle belly, blurry vision, nausea and vomiting that keeps getting worse, bleeding that will not stop easily, or a seizure. Get to the hospital emergency room or labor and delivery unit.
All pregnant women should start prenatal care early and continue it through the pregnancy. This lets the provider find and treat conditions such as HELLP syndrome right away.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can review your symptoms, help with follow-up after a pregnancy complication, and coordinate with your ob-gyn.
Common questions
Is HELLP syndrome an emergency?
Yes. HELLP syndrome is a medical emergency, and women can die from it. Outcomes are most often good if it is diagnosed early.
Can HELLP syndrome happen after the baby is born?
Yes. Most often it develops in the third trimester, but sometimes it develops in the week after the baby is born.
Can HELLP syndrome come back in a later pregnancy?
Yes, it can. HELLP syndrome may return in up to 1 out of 4 future pregnancies.
Can HELLP syndrome be prevented?
No known way to prevent it exists, according to MedlinePlus. Starting prenatal care early lets your provider find and treat it right away.
Sources
- MedlinePlus - HELLP syndrome
- NICHD - What are the symptoms of preeclampsia, eclampsia, and HELLP syndrome?
- American College of Obstetricians and Gynecologists - Preeclampsia and High Blood Pressure During Pregnancy
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
