Standardized Mississippi Protocol Treatment of 190 Patients with HELLP Syndrome: Slowing Disease Progression and Preventing New Major Maternal Morbidity

Abstract

Early initiation of MP inhibits HELLP syndrome disease progression and severity.

Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum

“…Demir et al [29] proved that the treatment with mannitolo is not superior to the treatment with MgSO 4 in achieving neurological recovery. The corticosteroids can be used to treat concurrent haemolysis, elevation of liver enzymes and lowering of platelet count that occur in HELLP syndrome [30]. Theoretically, corticosteroids should reduce vasogenic oedema even if in literature there are no reports about steroids usage in patients with PRES [15].…”

Early identification of women with HELLP syndrome who need plasma exchange after delivery

“…Since March 2012, corticosteroids have been administered to all patients according to the Mississippi protocol (dexamethasone 10 mg + 10 mg + 5 mg + 5 mg i.m. every 12 hours) [2,5,6].…”

Thrombocytopenia in early pregnancy predicting partial haemolysis, elevated liver enzyme and low platelet count syndrome: a case report and review of literature

“…However, the recent evidence suggests insufficient data for benefits of overall clinical improvements, but justified in situations that mandates increased rate of recovery of platelets. 16,17 This include any patient with class 1 or class 2 HELLP syndrome regardless of gestational age or any patient with class 3/partial-incomplete HELLP syndrome regardless of gestational age who has eclampsia, severe epigastric pain, severe hypertension, or any major organ system morbidity.…”

“…The evidence is being conceivably obvious that both partial HELLP and complete HELLP are the continuum in the natural evolution of the same disease. 17 The flow chart (Figure 1) illustrates the initial approach and management of thrombocytopenia in pregnancy. The treatment goals include arrest, reverse, and shorten the disease process and prevent major maternal and neonatal morbidity.…”