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Dexamethasone in the post-partum treatment of HELLP syndrome
P Vigil-De Gracia1, E García-Cáceres
1Department of Obstetrics and Gynecology, Complejo Hospitalario Metropolitano de la Caja de Seguro Social, Panamá City, Panamá.
Objective:
To determine if the routine initiation of dexamethasone in patients with post-partum HELLP syndrome produces therapeutic benefits.
Method:
The puerperal courses of 17 mothers who initially received dexamethasone after delivery were compared to 17 other mothers with HELLP syndrome who received no corticosteroids during the puerperium course. Treated patients immediately received 10 mg of dexamethasone post-partum (intravenously) followed 12 h later by 10 mg and 10 mg at 24 h post-partum, to a total of 30 mg.
Results:
The steroid treated group had significant changes over time in platelet count. Relative to the control group the platelet count increased significantly by 30 h post-partum (P < 0.01). The blood pressure, urinary output, lactic dehydrogenase, aspartato aminotransferase and alanine aminotransferase values were not significantly different between the dexamethasone and control group at any time by 72 h post-partum.
Conclusion:
Parturients with HELLP syndrome who received a short course of post-partum dexamethasone therapy had an accelerated recovery from their platelet count, but not from their liver enzymes and blood pressure.