Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial.

Author(s): Katz L, de Amorim MM, Figueiroa JN, Pinto e Silva JL

Affiliation(s): Department of Obstetrics, Professor Fernando Figueira Institute for Maternal and Child Health Care, Recife, Pernambuco, Brazil. katzleila@yahoo.com.br

Publication date & source: 2008-03, Am J Obstet Gynecol., 198(3):283.e1-8. Epub 2008 Jan 14.

Publication type:

OBJECTIVE: The purpose of this study was to determine the effectiveness of postpartum dexamethasone in patients with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. STUDY DESIGN: A prospective, randomized, double-blind trial was conducted in which 105 women with HELLP syndrome were enrolled and assigned randomly to treatment or placebo groups following delivery. Duration of hospital stay, maternal morbidity, and laboratory and clinical parameters were evaluated. RESULTS: There was no difference in maternal morbidity or mortality between the 2 groups. There was also no difference in duration of hospitalization and the need for rescue scheme or the use of blood products between groups. Linear model adjustments showed no significant difference between groups with respect to the pattern of platelet count recovery, aspartate aminotransferase, lactate dehydrogenase, hemoglobin, or diuresis. CONCLUSION: These findings do not support the use of dexamethasone in the puerperium for recovery of patients with HELLP syndrome.