Postpartum corticosteroids in HELLP syndrome – standard to prompt recovery

Gábor, Martin; Drab, Marek; Holomán, K

doi:10.4149/bll_2016_082

Cited by 6 publications

(4 citation statements)

References 47 publications

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“…In SR during years 2012-2014 vaginal delivery had only 10 (10.8 %) patients with HELLP syndrome and 83 (89.2 %) had caesarean section. Gabor et al in his case report (15) wrote , that patient with HELLP syndrome was primigravida with gestational diabetes mellitus. The onset of HELLP syndrome was on 35th weeks of gestation and she had caesarean section.…”

Section: Discussionmentioning

confidence: 99%

Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

M¹,

Krištúfková²,

Némethová³

et al. 2019

BLL

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OBJECTIVE: Hemolysis, Elevated Liver Enzymes, Low Platelets syndrome (HELLP syndrome) is one of the actively haunted maternal morbidity through Slovak Obstetric Survey System (SOSS), the organisation for surveillance of severe maternal morbidity and mortality in Slovakia. METHODS: The questionaires were sent in 55 Obstetric Units in Slovakia. The analyzed and here presented data had been collected cases those happened in the period from 1.1.2012 till 31.12.2014. Controls were women from SR during observed years, who delivered without HELLP syndrome. RESULTS: The return rate of questionnaires was 89.67 %, thus covering 146 972 deliveries during the study period in Slovakia. The exact incidence of HELLP syndrome was 0.63/1000 deliveries (CI 95 % 0.51-0.78). Risk factors were age > 30 (OR = 1.63), nuliparous (OR = 2.96), pregnancy after assisted reproduction technology (OR = 8.29) and multiple pregnancy OR = 9.19). The mean gestation age at delivery was 33.8th weeks. Vaginal delivery was by 10 (10.8 %) patients with HELLP syndrome and in the 83 (89.2 %) patients pregnancy was terminated with acute caesarean section. There were reported 45 050 cases (30.7 %) of the caesarean section in the control group throughout the study period. CONCLUSION: The older age, nulliparity, multiple pregnancy and pregnancy after assisted reproduction techniques was identifi ed as a signifi cant risk factors of HELLP syndrome (Tab. 5, Fig. 1, Ref.

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Section: Discussionmentioning

confidence: 99%

Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

M¹,

Krištúfková²,

Némethová³

et al. 2019

BLL

View full text Add to dashboard Cite

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“…Furthermore, evaluation of the fetus’s condition in the uterus and timely termination of pregnancy are performed in HELLP syndrome. 2,3 Among them, glucocorticoids play a vital role in treating HELLP syndrome, but this treatment has been controversial in the past 20 years. Some studies have shown that high-dose hormonotherapy is effective for alleviating the maternal and fetal prognoses and accelerating postnatal recovery.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of high-dose glucocorticoids on hemolysis, elevating liver enzymes, and reducing platelets syndrome

et al. 2018

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Objective To investigate the effectiveness of high-dose glucocorticoids on hemolysis, elevating liver enzymes, and reducing platelets (HELLP) syndrome. Methods A total of 151 patients with HELLP syndrome were analyzed and divided into two groups. Six subgroups of treatment and control groups were divided into three grades in accordance with the American Mississippi Diagnostic Criteria. Results There were no differences in general characteristics of the patients, primipara rate, minimum platelet recovery time, postpartum hemorrhage volume, postpartum hemorrhage rate, cumulative average of maternal damage, intensive care unit admission rate, perinatal mortality rate, and overall incidence rate of adverse outcomes in fetuses among the groups. The primipara rate in the control group of the third grade was significantly higher than that in the treatment group of the third grade. The treatment group of the second grade (88.7%) had a significantly higher preterm delivery rate than that in the control group of the second grade (66.7%). There were no differences in minimum hemoglobin, and maximum lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase levels among the groups and subgroups. Conclusion High-dose glucocorticoids cannot significantly improve maternal and fetal prognoses and laboratory indices. However, our results might offer some clinical evidence for HELLP syndrome therapy.

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“…Demgegenüber gibt es auch andere Arbeitsgruppen, die den Nutzen der Glukokortikoid-Applikation in Frage stellen [17]. Bei postpartalem HELLP-Syndrom oder anhaltend pathologischen Laborwerten kann die Gabe von Glukokortikoiden auch nach der Entbindung erwogen werden [18]. Wir führten bei unserer Patientin eine Eklampsie-Prophylaxe mit Magnesiumsulfat postpartal durch.…”

Section: Introductionunclassified

Fallbericht Leberruptur bei fulminantem HELLP-Syndrom in der 37. SSW

Findeklee

2018

Z Geburtshilfe Neonatol

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HELLP syndrome, characterized by the triad of hemolysis, elevated liver enzymes due to liver impairment, and low platelet count, is a hypertensive disorder in pregnancy. Although it is said to be caused by disturbed placentation in the first trimester, its clinical presentation can be seen mostly in the third trimester, but never before the completed 20 gestational week. Predictive for its diagnosis is the reported upper abdominal pain that normally is localized under the right arc of ribs. With the aid of laboratory examination, the suspected diagnosis can be confirmed or excluded. Therapeutic options are observational treatment with the prophylaxis of respiratory distress syndrome and attempting to prolong pregnancy with the help of steroids like dexamethasone, or delivering the infant by inducing labor or performing a primary caesarian section, depending on the gestational week. Delivery is the unique causal therapy of HELLP syndrome. Clinical management is mainly influenced by the course of HELLP syndrome. There are mild forms that allow prolonging the pregnancy for several days or sometimes weeks, but also foudroyant courses with acute liver damage. We report the case of a 40-year-old, gravida 1 woman in gestational week 36+1 who was brought to our hospital in hemorrhagic shock caused by a rupture of the liver due to acute HELLP-syndrome.

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Postpartum corticosteroids in HELLP syndrome – standard to prompt recovery

Cited by 6 publications

References 47 publications

Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

Active surveillance of incidence and risk factors of hemolysis, elevated liver enzymes and low platelets syndrome in Slovakia

Effectiveness of high-dose glucocorticoids on hemolysis, elevating liver enzymes, and reducing platelets syndrome

Fallbericht Leberruptur bei fulminantem HELLP-Syndrom in der 37. SSW

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