Effects of postpartum corticosteroids in patients with HELLP syndrome

Yalçın, Ömer; Şener, Turgay; Hassa, Hikmet; Özalp, Sinan; Okur, Ali

doi:10.1016/s0020-7292(98)00036-8

Cited by 57 publications

(41 citation statements)

References 15 publications

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“…2,7,17) Some patients with HELLP syndrome associated with DIC require multiple transfusions, 2,17) and corticosteroid therapy is recommended to reverse thrombocytopenia resulting from the HELLP syndrome. 11,18,20,25) Our patient received corticosteroid for treating the acute cerebral edema, elevated liver enzyme levels, and thrombocytopenia, all of which resolved 7 days after the cesarean section. Hypothermia was induced to treat the increase in intracranial pressure to over 200 mmH 2 O after the evacuation of the intracerebral hematoma.…”

Section: Discussionmentioning

confidence: 98%

Late Occurrence of Diffuse Cerebral Swelling After Intracerebral Hemorrhage in a Patient With the HELLP Syndrome. Case Report.

Hashiguchi

Inamura

Irita

et al. 2001

Neurol. Med. Chir.(Tokyo)

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Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome can occur at any time in the course of pregnancy and is associated with many complications including fatal stroke. A 37-yearold female presented with HELLP syndrome causing an intracerebral hematoma, which was treated by evacuation and mild hypothermia. Unexpected diffuse cerebral swelling occurred on the 15th day of the initially favorable postoperative course. Considerable impairment of consciousness persisted despite conservative therapy. Serial computed tomographic findings indicated delayed cerebral vasospasm as the cause of the swelling. Particularly careful management is required even beyond the first 2 weeks for patients with stroke as a complication of HELLP syndrome.

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Section: Discussionmentioning

confidence: 98%

Late Occurrence of Diffuse Cerebral Swelling After Intracerebral Hemorrhage in a Patient With the HELLP Syndrome. Case Report.

Hashiguchi

Inamura

Irita

et al. 2001

Neurol. Med. Chir.(Tokyo)

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“…Magann et al (1994), VigilDe Gracia andGarcía-Cáceres (1997) and Yalcin et al (1998) advocated the administration of high dose dexamethasone (10, 10, 5, 5 mg) over 36 h to patients with HELLP syndrome and the conclusion was that it appeared that those treated with the steroid recovered faster from the disease process measured by mean arterial pressure, urinary output, platelet count, LDH and AST. The steroid usage has increased the treatment options for HELLP syndrome, which would have consisted of supportive care and hopeful waiting, with management of complications as they arise.…”

Section: Discussionmentioning

confidence: 99%

HELLP syndrome: The experience at Ile-Ife, Nigeria

Makinde

Adegoke

Adediran

et al. 2009

Journal of Obstetrics and Gynaecology

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Between 1 January and 31 December, 2006, 34 consecutive cases of severe pre-eclampsia (12), imminent eclampsia (10) and eclampsia (12) who were admitted at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife in the south-western part of Nigeria, were investigated for the development of HELLP (haemolysis, elevated liver enzymes and low platelet count) syndrome in a prospective study. The ages of the women ranged from 18 to 38 years, parity 0-5 and the estimated gestational age from 18-41 weeks at presentation. A total of 26 (76.5%) of the patients were unbooked, six (17.6%) of the 34 cases developed HELLP syndrome. Four (33%) of the 12 eclamptics developed HELLP syndrome, while only one (10%) of the cases of imminent eclampsia and 1 (8.3%) of severe pre-eclamptic cases developed the syndrome. Using the Mississippi Triple class system, none of the HELLP syndrome cases belonged to Class I; 4 were categorised in Class II while 2 were in Class III. All of the four eclamptic cases with HELLP syndrome died giving a 100% fatality rate while none of the imminent eclamptic and severe pre-eclamptic patients with the syndrome died. Furthermore, there were six (15.8%) perinatal deaths among the 38 infants delivered by the 34 mothers with severe pre-eclampsia/eclampsia. Our data suggest that the development of HELLP syndrome is more likely in eclamptic patients and when it occurs in them, it is highly fatal. Most of the cases in this study were unbooked. Substandard care may have contributed to the progression of the disease state and consequently, to maternal mortality. It is imperative to draw up an action plan for the identification of the risk factors for the development of pre-eclampsia/eclampsia at peripheral hospitals and maternity centres and for prompt referral of such cases afterwards. Efforts should also be geared towards the minimising of treatment delay in all phases, so as to minimise both perinatal and maternal morbidity and mortality.

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“…Avant 2000, quatre petites études randomisées « corticoïde versus pas de traitement » ont montré les bénéfices potentiels de l'attitude expectative (Tableaux 3 et 4) [9][10][11][12]. Toutes utilisaient la dexaméthasone, une en période d'antepartum, trois dans le post-partum.…”

Section: Discussionunclassified