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Maternal benefit of high-dose intravenous corticosteroid therapy for HELLP syndrome
James N Martin1, Brad D Thigpen, Carl H Rose
1Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Objective:
We compared maternal outcomes for patients with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome treated with or without high-dose corticosteroids to ameliorate maternal disease.
Study Design:
An analysis of data for patients with HELLP syndrome (platelets,
Results:
Corticosteroid use increased from 16% (39/246 patients) for fetal indication from 1985 to 1991 to 90% (205/228 patients) for maternal-fetal indications from 1994 to 2000. Significantly reduced composite maternal disease from 1994 to 2000 was evidenced by improvements in laboratory parameters, disease progression to class 1 HELLP syndrome, the degree of hypertension, the need for antihypertensive therapy, the use of transfusion, and the presence of maternal morbidity (P<.05). Indices of postpartum recovery also were shortened significantly (P<.001).
Conclusion:
Routine early initiation of high-dose intravenous corticosteroids for patients with HELLP syndrome significantly lessened maternal disease, reduced maternal morbidity, and expedited recovery.
