Effects of postpartum corticosteroids in patients with HELLP syndrome

HELLP sendromu hastaların tedavisinde postpartum kortikosteroid kullanımının etkileri

Abstract

OBJECTIVE: In this study, we aimed to investigate and compare clinical and laboratory effects of dexamethasone and betamethasone and standard theraphy over patients with postpartum HELLP syndrome. MATERIALS-METHODS: 60 patients were included to this study all of whom were diagnosed of HELLP syndrome. Patients were evaluated prospectively within three groups, each consisting of 20 women selected randomly. To the first group dexamethasone, to the second group betamethasone is administered. At the same time 1st and 2nd groups were administered MgSO4 infusion. Third group was only administered standart MgSO4 infusion theraphy. RESULTS: Clinical was similiar between groups at the start of study. Within the first 42 hours there was no statistically significant difference among the three groups in terms of platelet increasing rate. Exceeding 42 hours platelet increasing rate of dexamethasone group was significantly higher than other groups ( p< 0.005). In terms of urine output there were no significant difference among the three groups within first 44 hours, however after exceeding 44 hours urine output was higher in betamethasone group than other two groups. Among the three groups there were no statistically significant difference in terms of AST, ALT, LDH decreasing rates, MAP values. In terms of major complications such as postpartum bleeding, eclampsia, acute renal failure there were no significant difference among the three groups, just as in the time length of hospital staying.DISCUSSION: Based on these findings, from laboratory parameters, dexamethasone administration has a positive effect on platelet increasing rate and from clinical parameters, betamethasone administration has a positive effect on urinary output. However in this study, question of whether dexamethasone or betamethasone should be the agent of choice in HELLP syndrome patients has not been answered clearly, thus we suppose that there is need for further studies in this subject.

Özet

AMAÇ: Bu çalışmada, postpartum HELLP Sendromlu hastalarda deksametazon, betametazon ve standart tedaviyi karşılaştırarak klinik ve laboratuar etkilerini araştırmayı amaçladık.MATERYAL VE METOT: HELLP Sendromu tanısı konulan 60 hasta çalışmaya alınmıştır. Hastalar prospektif randomize olarak yirişer kişilik üç grup olarak değerlendirildi.Birinci gruba dexametazon, ikinci gruba betametazon tatbik edilmiştir. Her iki gruba aynı zamanda eklamptik konvülzyon proflaksisi için standart tedavi olarak MgSO4 infüzyonu verilmiştir. Üçüncü gruba ise sadece standart tedavi olan MgSO4 infüzyonu verilmiştir. SONUÇLAR: Hastaların çalışma öncesi belirlenen klinik özellikleri her iki grupta benzerdi. Platelet yükselme hızında 42. saate kadar üç grup arasında istatistiksel açıdan anlamlı bir fark saptanmadı. 42. saaten itibaren deksametazon grubundaki platelet yükselme hızında diğer gruplara oranla istatistiksel açıdan anlamlı artış saptandı (p