[Corticosteroids in the treatment of HELLP-syndrome?].
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.


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.


CONCLUSIONS
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.
Svenningsen
Rune
R
Kvinneklinikken, Sykehuset Telemark, 3710 Skien. rsvennin@online.no
Morken
Nils-Halvdan
NH
Kahn
Jarl A
JA
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001623:Betamethasone / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D017359:HELLP Syndrome / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008428:Maternal Mortality; D011247:Pregnancy; D011379:Prognosis; D011644:Puerperal Disorders / Q000097:blood / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D003907:Dexamethasone; D001623:Betamethasone