title: Corticosteroids, pregnancy, and HELLP syndrome: a review.
abstract: Corticosteroids are potent antiinflammatory and immunosuppressive drugs, which are used in the treatment of a wide range of medical disorders. During pregnancy, several corticosteroids are administered for maternal as well as fetal reasons. Prednisone and prednisolone show limited transplacental passage and are thus used for treatment of maternal disease. Dexamethasone and betamethasone, drugs that can easily cross the placenta, are more suitable for fetal indications. During the last decade, administration of corticosteroids was introduced in the treatment of hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome), a severe form of preeclampsia unique to human pregnancy. Several randomized, controlled trials as well as other prospective and retrospective studies have been performed to investigate this beneficial effect of corticosteroids on biochemical measures and clinical signs. This review discusses the characteristics of corticosteroids in humans and details the use of corticosteroids during pregnancy. A review of literature on the effect of corticosteroids on HELLP syndrome is given and possible mechanisms of action are discussed.
authors.affiliation: Department of Perinatology and Gynecology, University Medical Center, Utrecht, The Netherlands. heimel@hotmail.com
authors.forename: P J
authors.initials: PJ
authors.lastname: van Runnard Heimel
authors.forename: A
authors.initials: A
authors.lastname: Franx
authors.forename: A F A M
authors.initials: AF
authors.lastname: Schobben
authors.forename: A J M
authors.initials: AJ
authors.lastname: Huisjes
authors.forename: J B
authors.initials: JB
authors.lastname: Derks
authors.forename: H W
authors.initials: HW
authors.lastname: Bruinse
mesh_terms: D000305:Adrenal Cortex Hormones / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D017359:HELLP Syndrome / Q000188:drug therapy*; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
chemical_list: D000305:Adrenal Cortex Hormones