Why does HELLP syndrome cause severe abdominal pain in pregnancy?

Severe Abdominal Pain in Pregnancy is a common presentation of HELLP Syndrome because liver inflammation and swelling can stretch its surrounding capsule. The pain is often felt in the upper right abdomen or under the ribs and may spread to the back or shoulder.

HELLP stands for haemolysis, elevated liver enzymes, and low platelets. The condition affects blood cells, liver function, and clotting. Changes in the liver can cause tenderness and pressure beneath the ribs. Nausea, vomiting, headache, visual changes, or a general feeling of illness may occur alongside the pain.

The pain cannot be safely explained by pregnancy discomfort alone. A maternity team may check blood pressure, blood counts, liver tests, urine, and the baby’s wellbeing. Results help determine how urgently treatment and delivery planning are needed.

If you have severe or persistent upper-abdominal pain during pregnancy, contact your maternity unit immediately and describe its location, onset, and associated symptoms. Do not drive yourself if you feel faint or confused. Take only medicines approved by your pregnancy care team, and do not wait for a routine appointment or for the pain to settle on its own.

Call emergency services for severe pain with fainting, heavy bleeding, difficulty breathing, chest pain, confusion, seizures, or severe headache and visual disturbance. Urgent assessment is also needed for reduced fetal movement or repeated vomiting. HELLP can worsen quickly, so immediate contact with maternity services is appropriate even if you are unsure of the cause.

Ask: Could this pain be related to HELLP or another pregnancy emergency? Which blood and urine tests are needed? How will you monitor my liver, platelets, blood pressure, and baby? What symptoms mean I should return immediately?