Prolongation of pregnancy in patients with HELLP syndrome using methylprednisolone : a retrospective multicentric analysis

Abstract

Background: Immediate delivery is an established concept for preventing life-threatening complications in mothers with HELLP syndrome; however, it is associated with preterm births. Methods: Cases of HELLP syndrome diagnosed at the university hospitals of Halle and Magdeburg (Germany) were analyzed retrospectively. Each patient of the treatment group was administered 64 mg of methylprednisolone (MP) intravenously for 10 days, with the dosage being reduced by 50% every other day in patients from Halle (n = 65). Almost immediate delivery was performed in the control groups (n = 45, Halle; n = 28, Magdeburg). Results: Pregnancies in the treatment group were prolonged by 4 days (median 1–55 days). The platelet counts increased from 76,060 ± 22,900/μL to 117,430 ± 39,065/μL in the MP group compared with an increase from 66,500 ± 25,852/μL to 83,430 ± 34,608/μL in control group 1 and from 78,890 ± 19,100/μL to 131,080 ± 50,900/µL in control group 2 (p < 0.001). Severe neonatal complications were significantly reduced in the treatment group (p < 0.05): sepsis, 9.25% vs. 24%; ventilation, 44.6% vs. 46.5%; and infant death, 1.6% vs. 8.6%. Conclusions: In a selected collective of patients with HELLP syndrome, prolongation of pregnancy using MP treatment improved maternal and neonatal outcomes.