by laura (5139 Posts), Sat Nov 15, 2003 01:03 am
Hey there! I've been thinking about your post for a couple of days-
It's really important that we answer questions like yours... but we're not doctors, so we have to be really careful not to give out incorrect information or try to be presumptious and guess what may be going without being a doc and without looking at your records and labs. I did look up some of the information about Hellp in a really good PE book I have, but you can't just go by that, you have to call your doc and have them explain your labs to you, and explain the rationale behind their treatment plan.
Hellp stands for Hemolysis, ELevated liver enzymes,and LP low platelets. It is my understanding that you don't necessarily have to have all parts of the syndrome to be diagnosed, but I'm not sure exactly what that means. Does matching one of the criteria count? I'm not sure. In Chesley's Hypertensive Disorders of Pregnancy (p 219) they list the criteria for diagnosis of HELLP:
Abnormal peripheral smear (schistocytes, burr cells)
Lactate dehydrogenase (LDH)> 600 U/L or bilirubin >1.2 mg/dL
Elevated Liver Enzymes:
Asparate amniotransferase (AST) > 70 U/L
Platelet count < 100,000 uL
(postscript mentioned, these "... represent an average twice the upper limits of normal at Univ. Tenn for LDH and AST")
So, I have two main thoughts on your question 1) you really have to understand the context of all your labs before you can make a guess, and 2) your provider has some explaining to do. Abnormal liver labs aren't so great. Elevated liver enzymes aren't great. If you are developing Hellp you should be inpatient in the hospital. I don't know enough about each labs' signifigance to say which one is the most important- just that we don't want to mess around with our livers, especially in pregnancy. I hope that right now you are well and healthy, and please check in and tell us what happens!
take care, and I hope this helped a little[:)]
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)