HELLP sendromunda deksametazon tedavisinin sonuçlar üzerine etkisi

Yıl 2019, Cilt: 52 Sayı: 1, 8 - 12, 14.03.2019

Hatice Kaya Özdoğan Sevtap Seyfettinoğlu Sibel Çetinalp Faruk Karateke Sibel Tetiker Raziye Narin

Öz

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

Öz

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. 

Anahtar Kelimeler

HELLP, Dexamethasone, Corticosteroid

Kaynakça

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