Sibel TETİKER, Sibel ÇETİNALP, Hatice Kaya ÖZDOĞAN, Sevtap SEYFETTİNOĞLU, Raziye NARİN, Faruk KARATEKE

HELLP SENDROMUNDA DEKSAMETAZON TEDAVİSİNİN MATERNAL SONUÇLAR ÜZERİNE ETKİSİ

AMAÇ: Literatürde HELLP sendromunun tedavisinde kortikosteroid kullanımı ile ilgili çelişkili bilgiler bulunmaktadır. Bu çalışmanın amacı deksametazon tedavisinin maternal sonuçlar üzerindeki etkisinin araştırılmasıdır. YÖNTEMLER: Çalışmaya HELLP sendromu tanısı ile yoğun bakım ünitesinde izlenen 20 hasta dahil edilmiştir. Hasta yaşı, gestasyonel yaş, Mississipi sınflandırması, APACHE II skoru, hematolojik ve biyokimyasal ölçümler, mortalite ve yoğun bakım yatış günü gibi parametreler analiz edilmiştir. BULGULAR: Hastalardan ikisi çoklu organ yetmezliğine bağlı olarak ölmüştür. On iki hastaya deksametazon tedavisi verilmiş (Grup 1), 8 hasta ise kortikosteroid tedavisi almamıştır. Gruplar arasında yoğun bakım yatış süresi, transfüzyon gereksinimi ve mortalite açısından anamlı fark saptanmamıştır. Deksametazon tedavisi verilen grupta trombosit sayılarında artış daha fazla gerçekleşmiştir ancak bu artış istatistiksel fark yaratacak düzeyde olmamıştır. SONUÇ: HELLP sendromu tedavisinde dekzametazon kullanımı mortalite, yoğun bakım yatış günü ve trombosit sayılarında anlamlı bir fark yaratmamaktadır.

THE EFFECT OF DEXAMETHASONE TREATMENT ON MATERNAL OUTCOME IN HELLP SYNDROME

INTRODUCTION: There are still controversies in the literatureregarding the role of corticosteroids in the treatment of HELLPsyndrome. The aim of this study is to investigate the effect ofdexamethasone treatment on maternal outcome.MATERIALS AND METHODS: The study included 20 patientswho were followed in ICU with the diagnosis of HELLP syndrome.Data regarding the age, gestational age, Mississippi class, APACHEII score, hematologic and biochemical measurements, mortality andlength of ICU stay were analyzed retrospectively.RESULTS: Two patients died due to the multiple organ failure.Twelve patient received dexamethasone treatment (Group 1) andeight patients did not receive steroid treatment (Group 2). There wasnot any statistically significant difference in the length of ICU stay,mortality, and transfusion requirements between the groups. Thepatients receiving dexamethasone treatment showed an increasedimprovement in platelet count; however the difference was notstatistically significant.CONCLUSIONS: Dexamethasone treatment did not result in anyimprovement in mortality, length of ICU stay, and in the plateletcounts in patients with HELLP syndrome.

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