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

HELLP sendromunda deksametazon tedavisinin sonuçlar üzerine etkisi

Amaç: HELLP (Hemolysis, elevated liver enzymes, and low platelets) sendromu gebeliğin ciddi komplikasyonlarından birisidir. 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. İki intrauterine ve bir premature bebek ölümü gerçekleşmiştir. 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.

Anahtar Kelimeler:

HELLP, dekzametazon, kortikosteroid

The Effect of Dexamethasone Treatment on Maternal Outcome in HELLP Syndrome

Aim: HELLP (Hemolysis, elevated liver enzymes, and low platelets) syndrome is a serious complication in pregnancy. There are still controversies in the literature regarding the role of corticosteroids in the treatment of HELLP syndrome. The aim of this study is to investigate the effect of dexamethasone treatment on maternal outcome.Materials and methods: The study included 20 patients who were followed in ICU with the diagnosis of HELLP syndrome. Data regarding the age, gestational age, Mississippi class, APACHE II score, hematologic and biochemical measurements, mortality and length of ICU stay were analyzed retrospectively. Results: Two patients died due to the multiple organ failure. Two intrauterine, and one premature mortality occurred. Twelve patient received dexamethasone treatment (Group 1) and eight patients did not receive steroid treatment (Group 2). There was not any statistically significant difference in the length of ICU stay, mortality, and transfusion requirements between the groups. The patients receiving dexamethasone treatment showed an increased improvement in platelet count; however the difference was not statistically significant. Conclusions: Dexamethasone treatment did not result in any improvement in mortality, length of ICU stay, and in the platelet counts in patients with HELLP syndrome.

Keywords:

HELLP, Dexamethasone, Corticosteroid,

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