HELLP syndrome – pro
HELLP syndrome (hemolysis, elevated liver enzymes and low platelets) is an overlap syndrome with eclampsia and TTP which can cause a tendency to bleed and other complications.The only effective treatment is delivery of the baby. Several medications have been investigated for the treatment of HELLP syndrome, but evidence is conflicting as to whether magnesium sulfate decreases the risk of seizures and progress to eclampsia. The DIC is treated with fresh frozen plasma to replenish the coagulation proteins, and the anemia may require blood transfusion. In mild cases, corticosteroids and antihypertensives (labetalol, hydralazine, nifedipine) may be sufficient. Intravenous fluids are generally required. Corticosteroids may be able to normalise some of the abnormal biochemical changes caused by HELLP, as well as reduce hypertension. The review of trials of corticosteroids for women with HELLP (both during pregnancy and after the birth) found too little evidence to be sure of the effects.
Matchaba P, Moodley J. Corticosteroids for HELLP syndrome in pregnancy. Cochrane Database of Systematic Reviews 2004, Issue 1. Art. No.: CD002076
Sibai BM. Diagnosis, controversies, and management of HELLP syndrome. Obstet Gynecol. 2004;103:981–991.