The Effect of Corticosteroid Administration on Maternal Outcomes in Patients with Hellp Syndrome
DOI:
https://doi.org/10.59188/eduvest.v4i6.1480Keywords:
HELLP syndrome, Corticosteroids, Dexamethasone, Platelets.Abstract
HELLP syndrome is a hemolysis syndrome with microangiopathic blood smears, increased liver enzymes, and low platelets in pregnant and postpartum patients. HELLP syndrome may be a complication or progression of severe preeclampsia. The death rate due to HELLP syndrome is relatively high. The use of corticosteroids is expected to increase platelet counts, reduce LDH values, and reduce liver function parameters to speed up the duration of healing and reduce mortality. Corticosteroids inhibit endothelial activation, reduce vascular endothelial injury, increase hepatic blood flow, prevent thrombotic microvascular hemolysis, and reduce platelet consumption. Objective: To evaluate the effectiveness of corticosteroids in patients with HELLP syndrome. Method: This research was conducted using a literature review method by searching articles from Google Scholar, PubMed, and Science Direct. Results: Administration of corticosteroids can increase platelet counts, reduce AST/ALT values, and reduce the need for blood product transfusions. Conclusion: Corticosteroids effectively increase platelet counts in patients with HELLP syndrome.
References
Al Shehri, H. A., Al Asmari, A. K., Khan, H. A., Al Omani, S., Kadasah, S. G., Horaib, G. B., Al Buraidi, A., Al Sharif, A. A., Mohammed, F. S., & Abbasmanthiri, R. (2022). Association between preventable risk factors and metabolic syndrome. Open Medicine, 17(1), 341–352. https://doi.org/10.1515/med-2021-0397
Alkorashy, M., Al‐Ghamdi, B., Tulbah, S., Al‐Numair, N. S., Alhadeq, F., A Takroni, S., & Al‐Hassnan, Z. N. (2021). A novel homozygous SCN5A variant detected in sick sinus syndrome. Pacing and Clinical Electrophysiology, 44(2), 380–384.
Ananthy, V., Priyadharsini, R. P., & Subramanian, U. (2021). Pathogenesis, Diagnosis, and Management of Metabolic Syndrome: A Comprehensive Review. J Basic Clin Appl Health Sci, 4(2), 39–45.
Aziz, Z., Shareef, H., Afridi, E., Kashif, M., Hussain, M., Waseem, M., Shahid, T., Khan, M. A., Muntaha, S. T., & Silro, H. H. (2023). Combating Metabolic Syndrome through Non-Pharmacological Strategies: A Literature Review: Combating Metabolic Syndrome. Pakistan Journal of Health Sciences, 20–28. https://doi.org/10.54393/pjhs.v4i11.1145
Aguayo, M.Y.A., & Gracia, P.V.D. 2018. Dexamethasone in HELLP syndrome: experience in Bolivia. The Journal of Maternal-Fetal & Neonatal Medicine. ISSN: 1476-7058 (Print) 1476-4954 (Online)
Dejene, T.J., Assefa, D., Gezahegn, M. 2021. The Effect Dexamethasone Treatment On The Outcome of Patients With Antepartum HELLP Syndrome: A Prospective Cohort Study. Lancet Journal, Available at SSRN: https://ssrn.com/abstract=3807319 or http://dx.doi.org/10.2139/ssrn.3807319
Duley, L.A., Gulmezoglu, D., Henderson, S., & Chou, D. 2010. Magnesium sulphate and other anticonvulsants for women with pre-eclampsia. Cochrane Database Syst Rev :11, CD000025.
England. 2019. HELLP Syndrome: Pathogenesis and Clinical Findings. The Calgary Guide to Understanding Disease. https://calgaryguide.ucalgary.ca/hellp-syndrome-pathogenesis-and-clinical-findings/
Fonseca, J.E., Otero, J.C., & Messa C. 2019. Dexamethasone for the treatment of class I HELLP syndrome: A double-blind, placebo-controlled, multicenter, randomized clinical trial. Pregnancy Hypertension, Volume 17 Pages 158-164
Fahed, G., Aoun, L., Bou Zerdan, M., Allam, S., Bou Zerdan, M., Bouferraa, Y., & Assi, H. I. (2022). Metabolic syndrome: updates on pathophysiology and management in 2021. International Journal of Molecular Sciences, 23(2), 786.
Gabor, M., Drab, M., & Holoman, K. 2016. Postpartum corticosteroids in HELLP syndrome - standard to prompt recovery. Bratislavské Lekárske Listy, 117: 418–424
Heimel, P.J.V.R., Huisjes, A.J.M., Franx, A., Koopman, C., Bots, M.L., & Bruinse, H.W. 2005. A Randomised Placebo-Controlled Trial of Prolonged Prednisolone Administration to Patients with HELLP Syndrome Remote from Term. European Journal of Obstetrics & Gynecology and Reproductive Biology, 128, 187-193
Hosten, A.K., Bonitz, J., Thale, V., & Tchirikov, M. 2023. Prolongation of Pregnancy in Patients with HELLP Syndrome Using Methylprednisolone: A Retrospective Multicentric Analysis. Life, 13,1013.https://doi.org/10.3390/life13041013
Herlin, M. K., Petersen, M. B., & Brännström, M. (2020). Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome: a comprehensive update. Orphanet Journal of Rare Diseases, 15(1), 1–16.
Huang, R., Yan, L., Lei, Y., & Li, Y. (2021). Hypothyroidism and complicated sick sinus syndrome and acute severe psychiatric disorder: A case report. International Medical Case Reports Journal, 171–176.
Jha, B. K., Sherpa, M. L., Imran, M., Mohammed, Y., Jha, L. A., Paudel, K. R., & Jha, S. K. (2023). Progress in Understanding Metabolic Syndrome and Knowledge of Its Complex Pathophysiology. Diabetology, 4(2), 134–159. https://doi.org//doi.org/10.3390/diabetology4020015
Kang, S., Zhou, L., Wang, X., Li, Y., & Wang, Y. 2019. Effectiveness of High-Dose Glucocorticoids on Hemolysis, Elevating Liver Enzymes, and Reducing Platelets Syndrome. Journal of International Medical Research, Vol. 47(2) 738-747
Kemenkes RI. 2017. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Komplikasi Kehamilan. Jakarta: Menteri Kesehatan Republik Indonesia.
Li, Y., Ren, C., & Mao M. 2016. Prognostic factors of the efficacy of high-dose corticosteroid therapy in hemolysis, elevated liver enzymes, and low platelet count syndrome during pregnancy: a meta-analysis. Medicine, 95: e3203
Magann EF, Bass D, Chauhan SP, Sullivan DL, Martin RW, Martin JN. 1994. Antepartum corticosteroids: disease stabilization in patients with the syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP). Am J Obstet Gynecol. 171: 1148-1153. 10.1016/0002-9378(94)90054-X.
Mao M, & Chen C. 2015. Corticosteroid Therapy for Management of Hemolysis, Elevated Liver Enzymes, and Low Platelet Count (HELLP) Syndrome: A Meta-Analysis. Med Sci Monit, 21: 3777-3783 DOI: 10.12659/MSM.895220
Manaf, M. R. A., Nawi, A. M., Tauhid, N. M., Othman, H., Rahman, M. R. A., Yusoff, H. M., Safian, N., Ng, P. Y., Manaf, Z. A., & Kadir, N. B. A. (2021). Prevalence of metabolic syndrome and its associated risk factors among staffs in a Malaysian public university. Scientific Reports, 11(1), 8132. https://doi.org/10.1038/s41598-021-87248-1
Mendrick, D. L., Diehl, A. M., Topor, L. S., Dietert, R. R., Will, Y., La Merrill, M. A., Bouret, S., Varma, V., Hastings, K. L., & Schug, T. T. (2018). Metabolic syndrome and associated diseases: from the bench to the clinic. Toxicological Sciences, 162(1), 36–42. https://doi.org/10.1093/toxsci/kfx233
Mohamed, S. M., Shalaby, M. A., El-Shiekh, R. A., El-Banna, H. A., Emam, S. R., & Bakr, A. F. (2023). Metabolic syndrome: risk factors, diagnosis, pathogenesis, and management with natural approaches. Food Chemistry Advances, 3, 100335. https://doi.org/10.1016/j.focha.2023.100335
Niesłuchowska-Hoxha, A., Cnota, W., Czuba, B., Ruci, A., Ciaciura-Jarno, M., Jagielska, A., Wójtowicz, D., Kierach, R., Dąbrowski, K., & Sidorowicz, M. (2018). A retrospective study on the risk of respiratory distress syndrome in singleton pregnancies with preterm premature rupture of membranes between 24+ 0 and 36+ 6 weeks, using regression analysis for various factors. BioMed Research International, 2018.
Nilsson, P. M., Tuomilehto, J., & Rydén, L. (2019). The metabolic syndrome–What is it and how should it be managed? European Journal of Preventive Cardiology, 26(2_suppl), 33–46. https://doi.org/10.1177/2047487319886404
Rochlani, Y., Pothineni, N. V., Kovelamudi, S., & Mehta, J. L. (2017). Metabolic syndrome: pathophysiology, management, and modulation by natural compounds. Therapeutic Advances in Cardiovascular Disease, 11(8), 215–225. https://doi.org//10.1177/1753944717711379
Rodrigues, M. C., Maciel, E. da S., Quaresma, F. R. P., Sesti, L. F. C., Paiva, L. da S., Macedo Junior, H., Araújo, F. A. de, Fonseca, F. L. A., & Adami, F. (2021). Prevalence and factors associated with metabolic syndrome in a vulnerable population in northern Brazil: a cross-sectional study. Journal of Human Growth and Development, 31(2), 291–301. https://doi.org/10.36311/jhgd.v31.11410
Rus, M., Crisan, S., Andronie-Cioara, F. L., Indries, M., Marian, P., Pobirci, O. L., & Ardelean, A. I. (2023). Prevalence and risk factors of metabolic syndrome: A prospective study on cardiovascular health. Medicina, 59(10), 1711.
Suastika, K. (2020). The challenges of metabolic disorders in Indonesia: focus on metabolic syndrome, prediabetes, and diabetes. Medical Journal of Indonesia, 29(4), 350–353. https://doi.org/10.13181/mji.com.205108
Takahashi, A., Kita, N., Tanaka, Y., Tsuji, S., One, T., Ishiko, A., Kimura, F., Takahashi, K., & Murakami, T. 2018. Effect of High Dose Dexamethasone In Postpartum Women With Class 1 Haemolysis, Elevated Liver Enzymes And Low Platelets (HELLP) Syndrome. Journal Of Obstetrics and Gynaecology, 39(3):335-339. doi: 10.1080/01443615.2018.1525609
Van Lieshout L.C.E.W., Koek G.H., Spaanderman M.A., van Runnard Heimel P.J. 2019. Placenta derived factors involved in the pathogenesis of the liver in the syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP): A review. Pregnancy Hypertens, 18:42–48. doi: 10.1016/j.preghy.2019.08.004
Van Runnard, P.J., Frans, A., Schobben, A.F.A.M., Huisjes, A.J.M., Derks, J.B., & Bruinse, H.W. 2004. Corticosteroids, Pregnancy, and HELLP Syndrome: A Review. Obstetrical and Gynecological Survey: Vol 60 No 1
Wallace, K., Harris, S., Addison, A., & Bean, C. 2018. HELLP Syndrome: Pathophysiology and Current Therapies. Curr Pharm Biotechnol, 19(10):816-826.
Wasyluk, W., Wasyluk, M., Zwolak, A., & Łuczyk, R. J. (2019). Metabolic syndrome-diagnostics, pathophysiology and treatment. Journal of Education, Health and Sport, 9(8), 45–62.
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