Steroids in HELLP

Q: Dexamethasone is one of the mainstay treatments in HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets).

A) True

B) False

Answer: B

In contrast to previous beliefs and earlier studies, dexamethasone failed to show any improvement in HELLP syndrome. Larger studies have been unable to show any benefits in improving maternal outcome or perinatal/infant death, despite the improvement in platelet count in the steroid group.

#ob-gyn

#hepatology

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.

3. Woudstra DM, Chandra S, Hofmeyr GJ, Dowswell T. Corticosteroids for HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome in pregnancy. Cochrane Database Syst Rev 2010; :CD008148.