Could this be HELLP? No elevated blood pressure.

[WorriedWagon]

NC for this because I'd rather it not be linked back, just in case.

I'm 32+1w pregnant and I've had bad HG throughout. I'm now about a stone below my pre-pregnancy weight. Since about week 25 or so, my HG hasn't been too awful. I've had a pretty stressful last week so I don't know if this is stress related - to be honest, the few weeks beforehand were also pretty stressful but I actually felt better than I have at any other point in the pregnancy so I don't know if it's stress related or not.

I googled my symptoms (not ideal, I know) and it immediately suggested HELLP but I'm hoping some people on here can give me a bit more info/guidance on whether or not it sounds like that, and whether I should contact my Maternity Advice Line (no community midwife).

The symptoms of HELLP that I can find online:

• Rib pain - this is what I was googling about. I have a really horrible, sharp but bruised, pain on my right rib cage. I've had it for about five days or so. I can't lay down on that side, sometimes it feels worse than at other times but I haven't noticed any pattern.


• Fatigue - I'm exhausted. But I'm also pregnant so that's par for the course?


• Nausea and vomiting - I'm throwing up everything I eat but I'm able to keep down liquids. But I have HG so, throwing up is pretty common. But, for the past two months (ish) I've only been throwing up once or twice a day, now it's every time I try to eat anything, no matter how small (even thicker liquids like chocolate milk or smoothies) and the nausea is definitely worse.


• Weight gain or swelling - no weight gain but I do have swelling sometimes. The swelling goes up and down though. At one point I sent a picture of my foot to DH and he, so sweetly, replied "that's not a foot, it's just a leg with toe nails". I keep having to take my wedding ring off because it's crushing my fingers. I have a very definite water retention around my jawline, similar to moonface.


• Flu-like symptoms - I don't get high temperatures (it's an immune thing from when I was ill as a child) but, over the last two days, I've had periods of feeling really shaky, hot and sweaty, headaches, dizziness etc. But, it's not all the time. I have a mild cough that, truthfully, I think it just my throat hurting from being sick. I did a Covid test and it was negative.


• Vision changes - I keep fainting and, for about a minute before I do, I lose my vision completely in both eyes. I also sometimes see shiny floating dots (I'm sure that's the medical term) when I feel fine.

However, from my understanding HELLP is caused by pre-eclampsia and pre-eclampsia is high blood pressure. I have a blood pressure cuff and my blood pressure is within the normal range. So, that makes me think it can't be HELLP - but I can't find a clear answer on whether that's true or not. My heart rate is consistently very high, it wasn't before pregnancy - my resting heart rate on my FitBit is around 80bpm and if I try and do anything (like cook food or brush my teeth) it'll go up to around 140-150bpm. So, I don't know if that's related.

Has anyone had these symptoms during their pregnancy and know what it could be?

Phone your midwife and ask their advice would be my suggestion. No idea if you can have HELLP without raised blood pressure, but having had pre-eclampsia that didn't follow the textbook example of pre-eclampsia, just get proper medical advice.

Thank you. I know you're right but my maternity team at the hospital are very, very, very diligent. I know I shouldn't complain (they're amazing and I'm really grateful that they are) but this means that I know that if I phone them then they'll ask me to come in so they can assess me, just in case. The hospital is 2 hours away from where we are right now and I'm not able to drive at the moment - so I'd have to wait for DH to get home from work and we'd have to take DS with us (or leave DS with friends which means friends will worry about us going to the hospital and DS will be unsettled etc). Obviously, I would go if necessary but I'm just hoping to scope out if this sounds like I'm worrying about nothing or not because I don't want to waste everyone's time (DH's, the midwives, our friends etc) or worry anyone over nothing.

Definitely contact someone, it might well be a combination of things, but for peace of mind - phone!

(Not to panic you) I had HELLP syndrome, never had high blood pressure even when platelets bottomed out at 20something (should be over 140, if my memory is correct). Blood test would tell you your platelets and other things besides.

Sending best wishes!!!!

I guess your symptoms could be caused by a number of things. Have you had a liver function test? If it's HELLP then obviously your enzymes will be abormally elevated.

Another thing to possibly bear in mind is gallstones or obstetric cholestasis - I had the latter in both pregnancies, and was pretty unwell in my first pregnancy until the quacks realised what was going on (I didn't have much itching, oddly, so it went undiagnosed for ages). Again, it was only revealed by a liver function blood test.

Thank you - I was wondering whether this was possible. I didn't want to sound like an idiot thinking I might have HELLP with no high blood pressure if it's not possible. I hope you're all ok and recovered now?

I haven't had any tests done since my 20 week scan because I don't have a community midwife (I'm on the waiting list, but I've been waiting since week 5 so no real expectation I'll see anyone before the birth). I test my urine at home for ketones when my HG is bad.

It's weird that you mention itching - my veins have been really itchy and puffed up in my hands and fingers. Is that what you had? No itch anywhere else or redness or rash or anything, just puffy and very itchy hand veins.

Ok, I've got myself into a bit of a tizzy now. DH and I have agreed we'll phone the advice line tomorrow morning and see them tomorrow but, looking online, it says that if this is HELLP then the baby will be delivered ASAP - but all the resources I can find are from the US and there doesn't appear to be any NHS guidance on what happens. Is this the same in the UK? Will they really deliver the baby at 32 weeks?! Has anyone been through this?

You really need to call the unit asap. As in today, please don’t wait until tomorrow to call. You are describing symptoms of pre-eclampsia. Epigastric pain, and visual disturbance. You need to have your urine and bloods tested as soon as possible.

I developed HELLP at 31 weeks and my daughter was delivered at 31+5. HELLP is not something to wait and see what happens - it is really quite serious so please contact your hospital unit if you suspect HELLP.

I had right upper quadrant pain and vomiting when I went to the hospital. My daughter was delivered by emergency c-section within a couple of hours of arriving at hospital. She spent just over 4 weeks in the neonatal unit and is now a healthy 7 year old with no problems from her early arrival.

Good luck.

I am in the UK btw. The NHS were wonderful.

I've had HELLP twice. No high blood pressure either time. The first time ended badly. Second, my twins were born at 32 wks by emergency section. And are fine. I beg you to get checked. I nearly died both times. I'm not trying to scare you, but it's a very serious complication. I had no symptoms of pre eclampsia either time. No protein, no high blood pressure. But developed HELLP very very quickly. I hope you've been checked over?

I think you should definitely get checked out sooner rather than later. You can ring the unit now and explain your symptoms - they will be able to assess the risk.

Please get checked ASAP. A relative had HELLP. It didn't end well sadly. I don't want to scare you, but please get checked.

This is it. Its more serious than people know. And not widely publicised.

Thanks for the comments - and I'm so sorry to those who have lost someone. I'm in hospital now, not too sure what's going on. My bloods weren't great but I don't think I have HELLP based on what they said but my haemoglobin is low, there's protein in my urine and a few other bits. They've done a CT scan on my head because of the nature of the headaches and they're wanting to do an ultrasound of my liver and gallbladder. Fingers crossed everything is ok.

So glad u in hospital. Well not that, but you are getting checked. Hopefully not serious, but if is, you in the right place. Please keep us updated. And good luck.

It could be your gallbladder, my sister had all the same symptoms when she was pregnant with her first she's was throwing up nearly everyday with the pain in the rib, she had ultrasounds blood tests and no one could find the reason.

She was induced after I had to phone an ambulance for her and she had surgery straight after giving birth.

Hope you're ok @WorriedWagon . I've got everything crossed for you.

I had hellp but after an emcs due to pre eclampsia. I swelled up so much I looked like a Michelin man, my face was like a beach ball with skits for eyes. Mine was caused by the massive haemorrhage I had in theatre. I was put in HDU afterwards, my organs were failing & they thought I may die for the first 12 hours. My BP at it's highest was 240/120. It took me 3 months before I was anyway near completely well again.