When is caesarean section recommended for HELLP syndrome?

HELLP refers to haemolysis, elevated liver enzymes and low platelet levels. It is a serious pregnancy complication that can affect the liver, blood clotting and the mother's general condition. Clinicians assess blood pressure, symptoms, blood tests, baby's wellbeing and how far labour has progressed.

Birth is often planned when the risks of continuing the pregnancy outweigh the risks of early delivery. A caesarean may be advised if the mother or baby needs delivery without delay, the cervix is not ready, labour is not progressing, or vaginal birth could be unsafe. The exact plan is made by the obstetric and anaesthesia teams.

Follow the hospital team's instructions and report headache, visual changes, right-sided upper abdominal pain, nausea, breathlessness or reduced fetal movement. Treatment may include blood-pressure medicine, seizure prevention, blood tests, fluids and blood products when needed. Tell the team about medicines that affect clotting and any previous caesarean birth.

Seek emergency maternity care for severe headache, flashing lights or blurred vision, strong pain beneath the ribs, heavy bleeding, a seizure, fainting, breathing difficulty or markedly reduced baby movements. HELLP can worsen quickly, so waiting at home for symptoms to settle is unsafe.

What do my platelet and liver results mean for the birth plan? Is vaginal birth realistic in my current condition? What anaesthesia options are suitable? What monitoring will I need after delivery?