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High-Risk Pregnancy
Does anyone or has anyone had HELLP syndrome?
Here is a little history....I have been in the hospital since I was 29 weeks and now I am 32 weeks, due to preeclampsia and gestational diabetes (I have had high bp's, some headaches, little swelling). Anyway, last week my perinatologist came in told me they would be watching my platelets because mine were on the low end of normal, at 150,000. On Thursday of this week, my count came back at 122,000. My question is.... Do you think this could be the onset of HELLP syndrome? And also how far will they let them drop before deciding to deliver? I am so scared to have a c-section and from what I have read most times they have to do a c-section and you have to be put out completely due to the fact that you can't have a spinal or epi. Please help me, thanks.
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Re: Does anyone or has anyone had HELLP syndrome?
I'm so sorry you're dealing with this
From what I can recall, you really don't want your platelets to drop below 100,000. FWIW, at my hospital they won't give an epi unless your platelets are at least 70,000. What does the rest of your bloodwork look like? (Liver enzymes, etc.)
I'm so glad you're in the hospital and they're keeping a good eye on you! Also check out the forums at preeclampsia.org - the girls there are a wealth of information!
right, what are your live enzymes? If you have the high blood pressure, your platelets are dropping, AND your liver enzymes are elevated then that is the very definitely of HELLP. It could be the start but I'm sure they will be checking your levels daily to keep an eye out. Once your liver starts to get affected they will likely get the baby out because it will only get worse.
Have they given you betamethasone shots yet for fetal lung development?
As for the c-section, the decision will be up to the anesthesiologist. Every one has their own little guidlines as to how low they will go with the platelet count before deciding it would be best to do a general rather than spinal/epidural. They would discuss it with you I'm sure, but ultimately do what's best for both you and baby.
I was told that if my platelets got below 100,000 I wuld have to be put out completely for my c-section. I was able to go through it with a spinal (epi was not an option and the spinal was very easy). I was also on magnesium sulfate during the c-section but I didn't have to stay on it 24 hrs. after delivery like most people do because my BP was never high. I had no choice but to have a c-section because DD was breech.
I really hope that you aren't developing HELLP. It is not fun at all! My DD was delivered at 31w 6d and spent 31 days in the NICU. If you haven't gotten the steriod shots, ask for them! They work wonders on little lungs!
Good luck!
I had HELLP at 32 weeks and had an emergency c/s. I had no issues prior, the onset was sudden. I was fine one minute, vomitting the next, within an hour my liver was swollen into my lungs and I couldn't breathe and was in tremendous pain. I don't know what my platelets were, but I know they were abysmal. My bp was 214/115 so I was having an emergency c/s regardless of the other HELLP related issues. They did give me an epi, in spite of the low platelets...they were really worried I would not recover if they put me under completely (there was lots of hushed talk from the doctors to my DH about "trying to save her life"). Honestly, as awful as that was, the low platelets ended up causing the biggest issue for me. They were so low that my blood didn't fully clot after the c/s and I lost half my blood supply in hematomas across my entire abdomen. The recovery from that was unimaginable. I couldn't get out of bed at all for a full week and I couldn't stand straight for 6 weeks. But even worse, after my blood tranfusions, they put my on antibiotics and I caught c.diff. I had to stay in the hospital another week for that and I ended up needing antibiotics for 22 weeks.
If your platelets are low, your ob will plan for that after your c/s. My ob took lots of extra precautions when closing my incision (not that it helped, but I think my case is the exception).
Ok, I know, I am painting an awful picture here. But take from my story the following:
-the c/s was no big deal. That was the easiest part of the whole ordeal. I felt nothing.
- the most important thing is your life and the baby's life. If you have HELLP, the baby needs to come ASAP so you both can live. Having a preemie is tough, but if you look at my siggy, my 32 weeker is a happy, healthy 13 month old today. (more information in my blog). The Preemies board is a great resource, btw.
- all we went through was awful but it's our story and I think, as a family, we are stronger b/c of it. Just today I was in a Boot Camp class and I thought "Gosh, remember the state my body was in a year ago? I can't believe I can do this!" You will get through this and you will be a better, stronger, more resilient person b/c of it.
There are some other HELLP mamas on the Preemies board if you want more perspective.
I developed HELLP but fortunately was able to put of delivery until 35 weeks. That said, they told me they would not do an epi if my platelets dropped below 100,000 so they actually put the catheter in early - before I was even in labor (I was attempting to be induced). This allowed them to use the epi line for my c-section.
Good luck.
I delivered DS at 35 weeks due to severe pre-e and HELLP. I was awake for delivery because they got my epi in when my blood work came back showing my platelets were at 100,000. I was also told that I could not have the epi if they dropped below 100,000, so they got it in just in time. My platelets eventually dropped to close to 50,000.
I totally agree with the poster who said the c-section was no big deal. When you're dealing with HELLP, the last thing you need to fear is the c-section. Yes, it's a major surgery, but in comparison to your other issues, it is a no-brainer. After several weeks on bed rest, as soon as they told me I could get up out of that bed, I was up and moving. It will really help with your recovery to move as soon as they tell you you're able. If you stay in bed after you've been given the ok to move, you'll just get more stiff and sore.
Your baby, at this point, has an excellent chance at making it through delivery and having no long term complications. Prepare yourself for a NICU stay for your little one and look forward to how much stronger and informed the whole experience will make you. I'm currently 25 weeks pregnant with DS #2 and I feel so much more prepared having gone through the delivery I did with my first son.