Dexamethasone compared with betamethasone for glucocorticoid treatment of postpartum HELLP syndrome.
OBJECTIVE
To compare the efficacy of dexamethasone and betamethasone to ameliorate the course of postpartum hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome.


METHODS
A prospective, mixed randomized/non-randomized clinical investigation of patients with postpartum HELLP syndrome. Treatment with either dexamethasone or betamethasone was continued until there was evidence of disease recovery.


RESULTS
Baseline characteristics of both the dexamethasone (n=18) and betamethasone (n=18) groups were similar. Although the time to discharge from the obstetrical recovery room was not statistically significant between groups, reduction in mean arterial blood pressure was more pronounced in the dexamethasone group as compared with the betamethasone group (-15.3+/-1.4 mmHg vs. -7.5+/-1.4 mmHg, respectively, P<0.01). Patients in the dexamethasone group required less antihypertensive treatment than the betamethasone group (6% vs. 50%, P=0.01) and also had a decreased need for readmission to the obstetrical recovery room (0% vs. 22%, P=0.03).


CONCLUSIONS
This investigation supports the use of dexamethasone as the superior glucocorticoid to use for patients with postpartum HELLP syndrome.
Isler
C M
CM
Department of Obstetrics and Gynecology, East Carolina University Brody School of Medicine, Greenville, NC, USA.
Magann
E F
EF
Rinehart
B K
BK
Terrone
D A
DA
Bass
J D
JD
Martin
J N
JN
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001623:Betamethasone / Q000008:administration & dosage*; D001795:Blood Pressure Determination; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D017359:HELLP Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care; D011336:Probability; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D003907:Dexamethasone; D001623:Betamethasone