Critical care of HELLP syndrome with corticosteroids.

HELLP syndrome is a special type of severe preeclampsia that constitutes a management dilemma for obstetricians. The high maternal and perinatal morbidity (and rarely maternal mortality) that can result from this entity mandates continuing efforts to find an effective treatment or prevention. The traditional therapy for HELLP syndrome has been meticulous medical care of the mother, vigilant fetal surveillance, and timely delivery. Proposed new therapies to permit prolongation of preterm pregnancy and fetal maturation include vasodilation therapy using fluids and antihypertensives and intensive corticosteroid therapy using intravenously administered high dose dexamethasone, usually in a dose of 10 mg every 12 hours. The latter therapy appears to improve fetal and maternal health with the added benefit of accelerating postpartum recovery from HELLP syndrome.