Dexamethasone treatment does not improve the outcome of women with HELLP syndrome: A double-blind, placebo-controlled, randomized clinical trial - 18/08/11
, Fabián Méndez, MD, PhD a, Claudia Cataño, MD b, c, Fernando Arias, MD, PhD d
Reprints not available from the authors. Address correspondence to Javier E. Fonseca, Universidad del Valle, Obstetrics and Gynecology, Hospital Universitario del Valle, Cali, Valle 57, Colombia.Abstract |
Objective |
The purpose of this study was to determine the efficacy of dexamethasone for treatment of HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome.
Study design |
A prospective, double-blind clinical trial was conducted among 132 women with HELLP syndrome who were assigned randomly to treatment or placebo groups. Pregnant women in the experimental group received 10-mg doses of dexamethasone intravenously every 12 hours until delivery and 3 additional doses after delivery. Puerperal women received 3 10-mg doses of dexamethasone after delivery. The same schedule was used in the placebo group. The main outcome variable was the duration of hospitalization. In addition, we evaluated treatment effects on the time to recovery of laboratory and clinical parameters and on frequency of complications.
Results |
The mean duration of hospitalization of patients who received dexamethasone therapy was shorter than in the placebo group (6.5 vs 8.2 days), but this difference was not statistically significant (P = .37). No significant differences were found in the time to recovery of platelet counts (hazard ratio, 1.2; 95% CI, 0.8-1.8), lactate dehydrogenase (hazard ratio, 0.9; 95% CI, 0.5-1.5), aspartate aminotransferase (hazard ratio, 0.6; 95% CI, 0.4-1.1) and to the development of complications. The results were found in both pregnant and puerperal women.
Conclusion |
The results of this investigation do not support the use of dexamethasone for treatment of HELLP syndrome.
Le texte complet de cet article est disponible en PDF.Key words : Dexamethasone, HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome, Clinical trial
Plan
| Supported in part by the Valle State Secretariat of Health; the dexamethasone and placebo were provided by Organon Laboratories, The Netherlands. |
Vol 193 - N° 5
P. 1591-1598 - novembre 2005 Retour au numéro
Article précédent
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