HELLP syndrome is a serious and potentially life-threatening complication that can occur during pregnancy, typically in the third trimester. The diagnosis of HELLP syndrome is based on a combination of clinical presentation, laboratory tests, and physical examination. Here’s a breakdown of the diagnostic criteria:

Clinical Presentation

• Abdominal pain, often severe and persistent
• Nausea and vomiting
• Fatigue
• Headache
• Visual disturbances

Laboratory Tests

• Complete Blood Count (CBC): Low platelet count (thrombocytopenia) is a hallmark of HELLP syndrome.
• Liver Function Tests (LFTs): Elevated liver enzymes, such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT), indicate liver damage.
• Lactate Dehydrogenase (LDH): Elevated LDH levels can indicate hemolysis (breakdown of red blood cells).
• Bilirubin: Elevated bilirubin levels can indicate hemolysis.

Physical Examination

• Blood Pressure: Hypertension is often present, but not always.
• Abdominal Examination: Right upper quadrant abdominal tenderness is common.

Diagnostic Criteria

A diagnosis of HELLP syndrome is typically made when a patient presents with:

1. Hemolysis (evidenced by elevated LDH, bilirubin, and/or schistocytes on peripheral smear)
2. Elevated liver enzymes (AST and/or ALT)
3. Low platelet count (less than 100,000/μL)

Classification

HELLP syndrome can be classified into three categories based on the severity of the disease:

1. Class 1: Severe thrombocytopenia (platelet count less than 50,000/μL), elevated liver enzymes, and hemolysis.
2. Class 2: Moderate thrombocytopenia (platelet count 50,000-100,000/μL), elevated liver enzymes, and hemolysis.
3. Class 3: Mild thrombocytopenia (platelet count 100,000-150,000/μL), elevated liver enzymes, and hemolysis.

Early recognition and diagnosis of HELLP syndrome are crucial to prevent maternal and fetal complications. If you suspect someone may have HELLP syndrome, it is essential to seek immediate medical attention.