PMID: 11904610Mar 21, 2002Paper

Maternal benefit of corticosteroid therapy in patients with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome: impact on the rate of regional anesthesia

American Journal of Obstetrics and Gynecology
J M O'brienJ R Barton

Abstract

Our purpose was to assess the impact of glucocorticoid administration on the rate of regional anesthesia in women with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Maternal records of pregnancies with HELLP syndrome managed between April 1994 and December 1999 were analyzed retrospectively. Sixty-nine patients were identified with antepartum HELLP syndrome and 46 (66%) received glucocorticoids. The presence of thrombocytopenia at admission and the interval from presentation to delivery was evaluated to assess the impact of glucocorticoid use. In the 37 women who had platelet counts of <90,000/mm3, 0 in the untreated group (0 of 11) versus 42% in the steroid group (11 of 26) received regional anesthetic, P =.015. Furthermore, the rate of regional anesthesia increased from 0 in the untreated group delivered within 24 hours (n = 10) to 57% (8 of 14) in the glucocorticoid group, in which women attained a 24-hour latency from presentation to delivery, P =.006. The need for general anesthesia also decreased significantly in treated women who attained a 24-hour latency compared to untreated women who did not, 100% (n = 7) versus 22% (n = 9), P =.003. Administration of glucocorticoids increases the use of...Continue Reading

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Citations

Dec 18, 2008·Archives of Gynecology and Obstetrics·Alev OzerNuri Danisman
Feb 28, 2009·BMC Pregnancy and Childbirth·Kjell HaramUlrich Abildgaard
May 24, 2013·Reproductive Health·Leila KatzUNKNOWN COHELLP Study Group
Mar 1, 2016·Journal of Obstetrics and Gynaecology of India·Anupama DaveAstha Jain
Dec 20, 2011·La Revue de médecine interne·O Pourrat, F Pierre
Oct 9, 2015·Acta Anaesthesiologica Scandinavica·M Del-Rio-Vellosillo, J J Garcia-Medina
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Nov 2, 2005·American Journal of Obstetrics and Gynecology·Baha M Sibai, John R Barton
Nov 8, 2011·Arthritis Research & Therapy·Linda van WykSicco A Scherjon
May 19, 2010·Annales Françaises D'anesthèsie Et De Rèanimation·A-S Ducloy-Bouthors
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Apr 5, 2005·Clinical Obstetrics and Gynecology·John M O'Brien, John R Barton
Jan 24, 2009·Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy·Shaun FergusonLinda Dodds
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Mar 12, 2009·Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy·L A MageeP von Dadelszen
Apr 25, 2006·American Journal of Obstetrics and Gynecology·James N MartinChristian M Briery

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