Q: 36-week pregnant patient presented with Right Upper Quadrant (RUQ) pain, elevated liver enzymes, severe hypertension (HTN), and thrombocytopenia. Patient is diagnosed with HELLP syndrome. The Obstetrics team is notified. Steroids have a beneficial effect in HELLP syndrome and should be used as an adjuvant treatment while awaiting delivery.
A) True
B) False
Answer: B
HELLP syndrome in pregnancy refers to the cluster of clinical myriad consists essentially of
- Hemolysis with a microangiopathic blood smear
- Elevated liver enzymes,
- Low platelet count
HTN is common, and that's why many experts (though controversial) consider it a form of preeclampsia. Birth is the cornerstone of the treatment.
Though once considered an adjuvant treatment, steroids have no role in HELLP syndrome.
#OB-Gyn
#hepatology
#hematology
References:
1. Fonseca JE, Méndez F, Cataño C, Arias F. Dexamethasone treatment does not improve the outcome of women with HELLP syndrome: a double-blind, placebo-controlled, randomized clinical trial. Am J Obstet Gynecol 2005; 193:1591.
2. Katz L, de Amorim MM, Figueiroa JN, Pinto e Silva JL. Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial. Am J Obstet Gynecol 2008; 198:283.e1.
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