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Q: In the July 2003 newsletter under Pregnancy Updates, many of the women mentioned taking an aspirin a day, extra folic acid, and extra calcium during their second pregnancies after experiencing HELLP the 1st pregnancy. Where I can read more about the benefits of these or could you pass this on to a Doctor for his/her explanation.
A: Aspirin has been studied in large clinical trials in first pregnancies and in complicated pregnancies. Very modest effects have been suggested. Aspirin is certainly not a "cure." Calcium has been studied in a large clinical trial in the United States - no effect. There has been a suggestion of effect in calcium deficient women in the developing world. A rare condition called hyper-homocysteinuria carries a risk for cardiovascular disease and preeclampsia. Folic acid helps these women. Folic acid also reduces the risk of neural tube defect and is reasonable to take prior to getting pregnant for these reasons.
Tom Easterling, M.D.
University of Washington
Q: Do you know if there is a comprehensive list of suggested tests that should be done on women suspected of having HELLP Syndrome?
A: These are the important tests.
Most Important
Maternal Blood pressure
Urinary protein - dip stick or 24
hour urine collection
Standard Tests
Renal Function
- serum creatinine
- 24 hour urine for creatinine
clearance (protein at the same
time)
Liver Function
- SGOT, SGPT (AST, ALT same
tests by different names)
Platelet Count
Fetal Condition
- NST nonstress test
- ultrasound for growth
- amniotic fluid assessment
Others - usually order only after the
diagnosis
- Tests for hemolysis (blood
smear, LDH, haptaglobin) not
usually needed
- Tests of liver (bilirubin, serum
glucose to rule out acute fatty
liver)
- Tests for Clotting (PTT, PT,
fibrinogen) only if very ill
- Tests for fetal condition (fetal
dopplers)
Thomas Easterling, M.D.
University of Washington
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