Effect of corticosteroids on HELLP syndrome: a case report.

The HELLP syndrome is associated with a high rate of prematurity, which is the major cause of neonatal morbidity and mortality. Several studies have demonstrated the feasibility of prolongation of pregnancies complicated by HELLP syndrome. Until now the role of an additive pharmacological regimen, and particularly the role of corticosteroids, is still not clear. We report a case of a successful prolongation of a pregnancy complicated by HELLP syndrome and note a direct relationship with application and withdrawal of corticosteroids. A 26-year old primigravida was admitted with HELLP syndrome in the 25th week of gestation. We commenced a therapy with 40 mg methylprednisolone i.v. once daily, with clinical symptoms and biochemical parameters improving within two days. On day 6 we discontinued steroid medication with a consecutive deterioration of all biochemical data and clinical symptoms. Corticosteroids were recommenced and within two hours an improvement of all symptoms and laboratory data was observed. Overall we were able to prolong the pregnancy for 33 days. This case report underlines the beneficial effect of corticosteroids in patients with HELLP syndrome. Thus steroids might be helpful for postponing deliveries in very preterm gestation and for stabilizing the maternal status.