Hemolysis — Fragmented Red Cells and Rising LDH
Microangiopathic hemolysis is the first HELLP hallmark.
- Present: Schistocytes (placeholder blood smear finding)
- >600 U/L: LDH (placeholder threshold)
- >1.2 mg/dL: Bilirubin (placeholder indirect fraction)
- Low: Haptoglobin (placeholder consumption marker)
Recognizing hemolysis on labs
Placeholder: hemolysis markers appear before overt symptoms.
Placeholder: LDH and smear review flag early hemolysis.
Elevated Liver Enzymes — AST/ALT Rise
Hepatocellular injury drives transaminases upward.
- >70 U/L: AST (placeholder elevated cutoff)
- >70 U/L: ALT (placeholder elevated cutoff)
- Possible: Liver tenderness (placeholder exam finding)
- Elevated: Capsule risk (placeholder hematoma risk)
Tracking enzyme trends
Placeholder: serial AST/ALT trends reveal worsening injury.
Placeholder: rapid enzyme rise warrants close monitoring.
Low Platelets — Thrombocytopenia
Platelet consumption marks disease severity.
- <100k/µL: Platelets (placeholder diagnostic cutoff)
- <50k/µL: Class 1 (placeholder severity class)
- Rising: Bleeding risk (placeholder clinical concern)
- Consider: Transfusion (placeholder threshold guidance)
Grading thrombocytopenia severity
Placeholder: platelet nadir correlates with complication risk.
Placeholder: falling platelets accelerate the care pathway.
Right Upper Quadrant Pain — Clinical Sign
RUQ or epigastric pain signals hepatic capsule strain.
- Common: RUQ pain (placeholder presenting symptom)
- Frequent: Nausea (placeholder associated symptom)
- Possible: Headache (placeholder overlapping sign)
- High: Exam urgency (placeholder triage priority)
Correlating symptoms with labs
Placeholder: pain plus abnormal labs raises suspicion sharply.
Placeholder: RUQ pain should prompt immediate lab review.
Urgent Delivery Decision — Trigger Point
Confirmed HELLP triggers time-critical delivery planning.
- Hours: Decision window (placeholder urgency scale)
- Case-based: Delivery mode (placeholder clinical judgment)
- Considered: Steroids (placeholder supportive measure)
- Continuous: Monitoring (placeholder maternal-fetal watch)
Triggering the delivery decision
Placeholder: combined criteria confirm need for urgent delivery.
Placeholder: delivery timing balances maternal and fetal risk.