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2015 ; 21
(ä): 3777-83
Nephropedia Template TP
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Corticosteroid Therapy for Management of Hemolysis, Elevated Liver Enzymes, and
Low Platelet Count (HELLP) Syndrome: A Meta-Analysis
#MMPMID26633822
Mao M
; Chen C
Med Sci Monit
2015[Dec]; 21
(ä): 3777-83
PMID26633822
show ga
BACKGROUND Hemolysis, elevated liver enzymes, and low platelet count (HELLP)
syndrome is a severe condition of pregnancy that is associated with significant
morbidity and mortality. Corticoteroid (CORT) therapy is common in the management
of HELLP syndrome. This study evaluates the efficacy of CORT therapy to patients
with HELLP Syndrome. MATERIAL AND METHODS A literature search was carried out in
multiple electronic databases. Meta-analyses of means difference and odds ratio
were carried under the random-effects model. RESULTS Fifteen studies (675 CORT
treated and 787 control HELLP patients) were included. CORT treatment
significantly improved platelet count (mean difference between CORT treated and
controls in changes from baseline, MD: 38.08 [15.71, 60.45]×109; p=0.0009),
lactic dehydrogenase (LDH) levels (MD: -440 [-760, -120] IU/L; p=0.007), and
alanine aminotransferase (ALT) levels (MD: -143.34 [-278.69, -7.99] IU/L; p=0.04)
but the decrease in aspartate aminotransferase (AST) levels was not statistically
significant (MD: -48.50 [-114.32, 17.32] IU/L; p=0.15). Corticosteroid treatment
was also associated with significantly less blood transfusion rate (odds ratio,
OR: 0.42 [0.24, 0.76]; p=0.004) and hospital/ICU stay (MD: -1.79 [-3.54, -0.05]
days; p=0.04). Maternal mortality (OR: 1.27 [0.45, 3.60]; p=0.65), birth weight
(MD: 0.09 [-0.11, 0.28]; p=0.38) and the prevalence of morbid conditions (OR:
0.79 [0.58, 1.08]; p=0.14) did not differ significantly between both groups.
CONCLUSIONS Corticosteroid administration to HELLP patients improves platelet
count, and the serum levels of LDH and ALT, and reduces hospital/ICU stay and
blood transfusion rate, but is not significantly associated with better maternal
mortality and overall morbidity.