Document Detail


Dexamethasone treatment does not improve the outcome of women with HELLP syndrome: a double-blind, placebo-controlled, randomized clinical trial.
MedLine Citation:
PMID:  16260197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine the efficacy of dexamethasone for treatment of HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome. STUDY DESIGN: A prospective, double-blind clinical trial was conducted among 132 women with HELLP syndrome who were assigned randomly to treatment or placebo groups. Pregnant women in the experimental group received 10-mg doses of dexamethasone intravenously every 12 hours until delivery and 3 additional doses after delivery. Puerperal women received 3 10-mg doses of dexamethasone after delivery. The same schedule was used in the placebo group. The main outcome variable was the duration of hospitalization. In addition, we evaluated treatment effects on the time to recovery of laboratory and clinical parameters and on frequency of complications. RESULTS: The mean duration of hospitalization of patients who received dexamethasone therapy was shorter than in the placebo group (6.5 vs 8.2 days), but this difference was not statistically significant (P = .37). No significant differences were found in the time to recovery of platelet counts (hazard ratio, 1.2; 95% CI, 0.8-1.8), lactate dehydrogenase (hazard ratio, 0.9; 95% CI, 0.5-1.5), aspartate aminotransferase (hazard ratio, 0.6; 95% CI, 0.4-1.1) and to the development of complications. The results were found in both pregnant and puerperal women. CONCLUSION: The results of this investigation do not support the use of dexamethasone for treatment of HELLP syndrome.
Authors:
Javier E Fonseca; Fabián Méndez; Claudia Cataño; Fernando Arias
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  193     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-01     Completed Date:  2006-01-19     Revised Date:  2006-12-21    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1591-8     Citation Subset:  AIM; IM    
Affiliation:
School of Public Health, Universidad del Valle, Cali, Colombia. jfonseca@univalle.edu.co
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anti-Inflammatory Agents / therapeutic use*
Dexamethasone / therapeutic use*
Double-Blind Method
Female
HELLP Syndrome / drug therapy*
Humans
Pregnancy
Pregnancy Outcome
Prospective Studies
Treatment Failure
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 50-02-2/Dexamethasone
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2006 Dec;195(6):e10; author reply e11-2   [PMID:  16635460 ]
Am J Obstet Gynecol. 2006 Dec;195(6):e7; author reply e8-9   [PMID:  16643818 ]
Am J Obstet Gynecol. 2006 Dec;195(6):e13-4; author reply e15-7   [PMID:  16677590 ]
Am J Obstet Gynecol. 2005 Nov;193(5):1587-90   [PMID:  16260196 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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