HELLP Sendromunda Postpartum Deksametazon Kullanımı

Yıl 2018, Cilt: 4 Sayı: 3, 251 - 255, 01.01.2018

Melih Velipaşaoğlu Gökhan Yavaş İbrahim Anıl Kulaksız H. Mete Tanır

Öz

Amaç: Önemli bir perinatal ve maternal morbidite ve mortalite sebebi olan HELLP sendromunda gebeliğin sonlandırılması dışında şu an için kanıtlanmış etkin bir tedavi metodu bulunmamaktadır.Çalışmanın amacı HELLP sendromu olgularında doğum sonrası uygulanan deksametazon protokolünün maternal mortalite, laboratuvar belirteçlerinin normale dönme süresi ve hastanede kalış süresine etkisini incelemektir.Gereç ve Yöntemler: Bu retrospektif çalışmaya Ekim 2001 ve Mayıs 2015 tarihleri arasında doğum yapan HELLP sendromu olguları dahil edilmiştir. Hastalar postpartum dönemde deksametazon uygulanma durumuna göre iki gruba ayrılmıştır. Grup 1’deki olgulara postpartum dönemde 4 gün boyunca 12 saat arayla intravenöz 10 mg deksametazon uygulanmışken grup 2’deki hastalara bu uygulama yapılmamıştı. Çalışmanın birincil sonucu hastanede kalış süresi, ikincil sonuçları ise laboratuvar bulgularının normale dönme süresi ve maternal mortaliteydi.Bulgular: Çalışmaya dahil edilen toplam 52 hastanın 25’ine %48,1 deksametazon uygulanmış, 27’sine %51,9 ise uygulanmamıştı. İki grup arasında hastanede kalış süreleri, trombosit sayısı ve karaciğer fonksiyon testlerinin normale dönem süreleri arasında istatistiksel olarak anlamlı herhangi bir fark tespit edilmemiştir. Çalışmada maternal mortalite gerçekleşmemiştir.Sonuç: HELLP sendromunda postpartum dönemde deksametazon kullanımı ile ilgili çeşitli çalışmalarda çelişkili sonuçlar bulunmaktadır. Bizim çalışmamızda da, deksametazonun hastanede kalış süresi ve laboratuvar bulgularının normalleşme süresine etkisi olmadığı gösterilmiştir

Anahtar Kelimeler

HELLP sendromu, Deksametazon, Maternal mortalite

Postpartum Dexamethasone Use in HELLP Syndrome

Öz

Objective: HELLP syndrome is an important cause of perinatal – maternal morbidity and mortality. There is currently no proven effective treatment method except the termination of pregnancy. The purpose of this study is to investigate the effects of postnatal dexamethasone protocol on maternal mortality, the duration of normalization of laboratory markers and hospital stay.Material and Methods: HELLP syndrome cases that delivered between October 2001 and May 2015 were included this retrospective study. The patients were divided into two groups according to the application of dexamethasone in the postpartum period. In Group 1, 10 mg of dexamethasone was administered intravenously every 12 hours in the postpartum period for 4 days, whereas this was not performed in Group 2. The primary outcome of the study was the length of stay in the hospital, the secondary outcomes were the normalization time of the laboratory findings and maternal mortality.Results: Of the 52 patients included in the study, 25 48.1% received dexamethasone and 27 51.9% did not. There was no statistically significant difference between the two groups in terms of hospital stay, platelet count, and duration of normalization of liver function tests. There was no maternal mortality in the study.Conclusion: There are conflicting results in various studies on the use of dexamethasone in the postpartum period in HELLP syndrome. In our study, dexamethasone has been shown to have no effect on the length of hospitalization and laboratory marker normalization

Anahtar Kelimeler

HELLP syndrome, Dexamethasone, Maternal mortality

Kaynakça

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