Effect of corticosteroid therapy in HELLP syndrome

Objective: The purpose of this study was to determine the effectiveness of corticosteroid treatment in patients with HELLP syndrome.

Methods: A retrospective study was conducted in which 62 women with HELLP syndrome were evaluated. 35 women were enrolled in a corticosteroid therapy group (IV urbason 32 mg with magnesium sulfate) and the data was subsequently compared to the 27 women in the control group without corticosteroid treatment. Duration of hospital stay, morbidity and mortality and laboratory and clinical parameters were evaluated in the women and their offspring.

Results: The mothers in the therapy group required significantly less platelet (p = 0.007) concentrate transfusions. The time from diagnosis to delivery is significantly longer in the therapy group and the difference in means constitutes 2.5 days (p = 0.002). The rate of spontaneous vaginal delivery in the therapy group was 17.9% compared to 6.5% in the control group. There were no significant differences concerning neonatal transfusions and complications. The only characteristic in which the neonates of the two groups differed significantly was the rate of reanimation with p = 0.04. 6 (19.4%) cases of reanimation in the control group (n = 31) and 1 case of reanimation in the therapy group (n = 38) were observed.

Conclusion: Our findings suggest that the use of corticosteroids in combination with magnesium sulfate in antepartum patients with HELLP syndrome prolongs pregnancy, higher rate of vaginal spontaneous delivery and less platelet concentrate transfusions. There was no significant difference in the fetal performance status.