What is HELLP Syndrome? How Will Foetal Distress Be Dealt with and Will I Feel It?

During pregnancy, expectant parents undergo various antenatal care procedures to ensure the health and well-being of both the mother and the baby. While most pregnancies proceed without complications, some conditions can arise that pose risks to both the mother and baby. One of these conditions is HELLP syndrome, a potentially life-threatening pregnancy complication that affects the liver and blood clotting. In this article, we will delve into what HELLP syndrome is, its signs, how foetal distress may be linked with it, and how it is managed in antenatal care. Additionally, we’ll address the ways in which expectant mothers might feel foetal distress during labour, and how healthcare providers manage this concerning situation. By understanding these topics in greater depth, expectant parents can be better prepared for the challenges that may arise during pregnancy.

What is HELLP Syndrome?

HELLP syndrome is an acronym for a rare but serious condition that stands for:

• Hemolysis: The breaking down of red blood cells.
• EL: Elevated liver enzymes, indicating liver damage.
• LP: Low platelet count, which can result in bleeding and clotting problems. This syndrome is considered a severe form of preeclampsia, which is a condition characterised by high blood pressure and organ damage, most commonly occurring after the 20th week of pregnancy. HELLP syndrome usually manifests during the third trimester or after childbirth but can sometimes develop earlier in pregnancy. It is important to note that HELLP syndrome is a medical emergency, and if left untreated, it can lead to serious complications such as liver rupture, bleeding, organ failure, and in extreme cases, death for both the mother and the baby. Thankfully, with proper antenatal care and close monitoring, the risks can be minimised.

How is HELLP Syndrome Detected?

Antenatal checkups and antenatal scans play an essential role in detecting complications like HELLP syndrome. During routine antenatal appointments, your healthcare provider will monitor blood pressure and check for signs of preeclampsia, which often precedes HELLP syndrome. Blood tests are commonly used to check liver function and platelet count, both of which can indicate the development of HELLP syndrome. Common symptoms of HELLP syndrome may include:

• Abdominal pain, particularly in the upper right side
• Nausea and vomiting
• Headaches
• Swelling, particularly in the hands and face
• High blood pressure
• Vision changes
• Protein in the urine If these symptoms are present, further tests and interventions may be required to ensure both the mother and baby’s health and safety.

How Does HELLP Syndrome Impact Foetal Health?

As HELLP syndrome can affect the placenta’s function, it can lead to foetal distress, a term that describes signs of fetal suffering, often due to a lack of oxygen or nutrients. The reduced blood flow and oxygen delivery to the baby caused by HELLP syndrome can result in complications such as intrauterine growth restriction (IUGR), low birth weight, or preterm birth.

Will I Feel Foetal Distress?

Expectant mothers may be concerned about whether they will feel foetal distress and how they will recognise it during labour. Foetal distress occurs when the baby’s oxygen supply is compromised, and it is usually detected through monitoring the baby’s heart rate and movement. During antenatal scans, your healthcare provider may already be keeping an eye on factors that could lead to foetal distress, such as the position of the baby or any issues with the placenta. As labour progresses, the signs of foetal distress are monitored closely through cardiotocography (CTG), which tracks the baby’s heart rate and the mother’s contractions. While antenatal care helps detect problems early, many women do not physically feel foetal distress. Instead, it’s typically discovered through monitoring during labour. However, some signs of foetal distress may include:

• A significant reduction in the baby’s movements
• Persistent or abnormal heart rates, detected through CTG
• Abnormalities in the mother’s contractions If foetal distress is identified, healthcare providers act swiftly to reduce the risks to both mother and baby.

How Is Foetal Distress Managed?

If foetal distress is detected, healthcare providers are trained to manage the situation promptly and efficiently to ensure the safety of both mother and baby. Here are some common methods for managing foetal distress:

1. Changing Maternal Position

A simple but effective way to manage foetal distress is to change the mother’s position during labour. For instance, if the mother is lying on her back, she may be asked to turn onto her left side, as this position can increase blood flow to the placenta and relieve pressure on the umbilical cord. This intervention is particularly important in cases where the umbilical cord is compressed, which can reduce the baby’s oxygen supply.

2. Oxygen for the Mother

If the baby is showing signs of distress, administering oxygen to the mother can help improve oxygen supply to the baby. Oxygen is typically provided through a face mask or nasal cannula, which can help prevent further deterioration in the baby’s condition.

3. Amnioinfusion

In cases where the umbilical cord is compressed, causing a reduction in oxygen supply, an amnioinfusion may be used. This involves the insertion of a catheter into the uterus to introduce sterile fluid, which may cushion the cord and reduce compression.

4. C-Section (Caesarean Section)

If foetal distress is severe and cannot be resolved through non-invasive interventions, a C-section may be recommended. A C-section involves a surgical delivery of the baby through the abdomen and can be necessary if there is a risk to the baby’s health, such as in the case of HELLP syndrome-related complications.

Antenatal Care: How Can It Help in Managing HELLP Syndrome and Foetal Distress?

Antenatal care is essential in ensuring both the health of the mother and the baby during pregnancy. Through antenatal appointments and regular monitoring, conditions like HELLP syndrome and foetal distress can be detected early, allowing for timely interventions. Antenatal scans and blood tests help identify any potential problems, ensuring that you receive the right treatment if complications arise. It is also important to attend antenatal classes and stay informed about the risks and signs of complications like HELLP syndrome and foetal distress. These classes can help you feel more confident and prepared when facing the unexpected. Additionally, antenatal support from your healthcare team, partner, and family can provide the emotional strength you need during challenging moments.

Prenatal Care to Prevent Foetal Distress and HELLP Syndrome

The risk of HELLP syndrome and foetal distress can be minimised with proper prenatal care. Here are some tips to help ensure a healthy pregnancy:

• Attend regular antenatal checkups: Regular visits to your antenatal clinic are vital for monitoring both maternal and foetal health.
• Take antenatal vitamins: Ensure you’re taking the appropriate antenatal vitamins, particularly those containing folic acid, which helps reduce the risk of complications.
• Stay active with antenatal fitness: Engage in antenatal yoga or gentle prenatal exercise to improve circulation, reduce stress, and keep your body prepared for labour.
• Stay hydrated and maintain a balanced diet: Good nutrition and hydration are key to a healthy pregnancy. Work with your healthcare provider to ensure you are consuming the right foods and nutrients for both you and your baby.
• Know the signs of complications: Be aware of symptoms such as swelling, headaches, or changes in vision, which could signal the development of HELLP syndrome or foetal distress.

Staying Prepared for Labour and Birth

Understanding conditions like HELLP syndrome, foetal distress, and how they are managed during pregnancy can help ease anxieties about the birth process. With proper antenatal care, careful monitoring, and timely interventions, most pregnancies can proceed without complications. Always consult with your healthcare provider about any concerns, and ensure you attend regular antenatal appointments and scans to monitor both your health and your baby’s wellbeing. The more informed and prepared you are, the better you’ll be able to manage any challenges that arise, ensuring the best possible outcome for both you and your baby.