Abstract | OBJECTIVES: To evaluate the effect of prolonged administration of high-dose prednisolone on early onset HELLP ( hemolysis, elevated liver enzymes, and low platelets) syndrome during expectant management. STUDY DESIGN: A randomized, double-blind trial was performed in 31 pregnant women with HELLP syndrome with an onset before 30 weeks gestation. Patients received either 50mg prednisolone or placebo intravenously twice a day. Primary outcome measures were the entry-to-delivery interval and the number of recurrent HELLP exacerbations in the antepartum period. RESULTS: Serious maternal morbidity was considerable, in particular in the placebo group where even on maternal occurred as a consequence of liver rupture. The mean entry-delivery interval did not differ between the prednisolone group (6.9 days) and the placebo group (8.0 days). However, patients in the prednisolone group had a significant lower risk of a recurrent HELLP exacerbation after the initial crisis had subsided, as compared to patients in the placebo group (HR 0.3, with 95% CI 0.3-0.9). Platelet count recovered faster in the prednisolone group as compared to the placebo group (mean 1.7 days versus 6.2 days, P<0.01). CONCLUSIONS:
HELLP syndrome remote from term causes high risk for serious maternal morbidity and mortality. When expectant management is pursued in selected patients with a HELLP syndrome remote from term, prolonged administration of prednisolone reduces the risk of recurrent HELLP syndrome exacerbations.
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Authors | Pieter J van Runnard Heimel, Anjoke J M Huisjes, Arie Franx, Corine Koopman, Michiel L Bots, Hein W Bruinse |
Journal | European journal of obstetrics, gynecology, and reproductive biology
(Eur J Obstet Gynecol Reprod Biol)
2006 Sep-Oct
Vol. 128
Issue 1-2
Pg. 187-93
ISSN: 0301-2115 [Print] Ireland |
PMID | 16412552
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anti-Inflammatory Agents
- Prednisolone
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Topics |
- Adult
- Anti-Inflammatory Agents
(administration & dosage)
- Double-Blind Method
- Drug Administration Schedule
- Female
- Gestational Age
- HELLP Syndrome
(drug therapy)
- Humans
- Prednisolone
(administration & dosage)
- Pregnancy
- Pregnancy Maintenance
(drug effects)
- Pregnancy Outcome
- Pregnancy Trimester, Second
(drug effects)
- Recurrence
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