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[Corticosteroids in the treatment of HELLP-syndrome?]
Rune Svenningsen1, Nils-Halvdan Morken, Jarl A Kahn
1Kvinneklinikken, Sykehuset Telemark, 3710 Skien. rsvennin@online.no
Background:
Haemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome is a severe form of preeclampsia. It is often manifested clinically by elevated blood pressure, proteinuria and abdominal pain. Women diagnosed with the HELLP-syndrome normally show evidence of recovery within the first 48 hours after delivery. There is however a small group of patients in which no arrest or reversal of the HELLP process can be seen after 72 hours post partum. These patients have a high incidence of maternal morbidity and mortality. Several studies have shown benefits to HELLP patients after administration of corticosteroids.
Material And Methods:
We have reviewed the literature for this treatment and present a case report as illustration. PubMed/Medline was searched with the key words "HELLP and corticosteroids" from 1990 to 2006. We have chosen to review the prospective and randomised studies.
Results And Interpretation:
None of the studies show statistically significant differences in maternal morbidity or mortality by administering corticosteroids to patients with HELLP syndrome. Treatment can give a faster increase in the platelet count for patients with platelets < 50 (10(9)/L), but larger trials are needed to support the use of corticosteroids for treatment of HELLP-syndrome.
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