title: Obstetric implications of antepartum corticosteroid therapy for HELLP syndrome.
abstract: OBJECTIVE
  We reviewed the impact of intravenous high-dose corticosteroid administration for preterm hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome on vaginal delivery rate and degree of clinically significant thrombocytopenia.
  
  
  METHODS
  Retrospective analysis of 1991-2000 HELLP syndrome (platelets < 100,000/uL, lactate dehydrogenase > 600 IU/L, aspartate aminotransferase and/or alanine aminotransferase > 70 IU/L) data focusing on labor inductions for gestations of less than 34 weeks and increase in platelet count sufficient to permit regional anesthetic techniques.
  
  
  RESULTS
  Antepartum high-dose corticosteroid use increased from 32% (1991-1995) to 67% (1996-2000) for 350 patients studied (n = 199, < 34 weeks; n = 151, > 34 weeks). Corresponding vaginal delivery rates were 32% for gestations of less than 30 weeks, 61% at 30-31 weeks, and 62% at 32-33 weeks. Similarly, 27% of patients with a platelet count of less than 75,000/uL and 52% with a platelet count of less than 100,000/uL who received high-dose corticosteroids during the study interval subsequently achieved a 100,000/uL threshold in time to perform regional anesthesia for delivery.
  
  
  CONCLUSIONS
  Administration of intravenous high-dose corticosteroids for preterm HELLP syndrome increases probability of successful labor induction and candidacy for regional anesthesia.
  
  
  METHODS
  II-3.
authors.affiliation: Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA. crose@ob-gyn.umsmed.edu
authors.forename: Carl H
authors.initials: CH
authors.lastname: Rose
authors.forename: Brad D
authors.initials: BD
authors.lastname: Thigpen
authors.forename: James A
authors.initials: JA
authors.lastname: Bofill
authors.forename: Julie
authors.initials: J
authors.lastname: Cushman
authors.forename: Warren L
authors.initials: WL
authors.lastname: May
authors.forename: James N
authors.initials: JN
authors.lastname: Martin
mesh_terms: D000765:Anesthesia, Conduction; D000773:Anesthesia, Obstetrical; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D017359:HELLP Syndrome / Q000188:drug therapy*; D006801:Humans; D007751:Labor, Induced; D010976:Platelet Count; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone