RECURRENT HELLP SYNDROME: IMPLICATIONS FOR MATERNAL-FETAL HEALTH

Abstract

Recurrent HELLP syndrome is a rare but highly serious obstetric complication characterized by microangiopathic hemolysis, elevated liver enzymes, and thrombocytopenia, often associated with preeclampsia. This condition presents significant maternal and perinatal morbidity and mortality, being more prevalent in women who experienced severe or early-onset HELLP syndrome. The pathophysiology of recurrence involves a complex interaction between genetic factors, endothelial dysfunction, angiogenic imbalances, and exacerbated inflammatory responses, contributing to hepatic, renal, and hematologic complications, as well as fetal compromise. Early detection, intensive prenatal monitoring, and a multidisciplinary approach are essential to minimize adverse outcomes, although there are still gaps in prevention and risk stratification. This narrative review summarizes the available evidence on recurrent HELLP syndrome, highlighting its implications for maternal and fetal health and the need for individualized clinical protocols.