当前位置： SCI文献检索 > AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY期刊下所有文献 > Maternal benefit of corticosteroid therapy in patients with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome: impact on the rate of regional anesthesia.

Maternal benefit of corticosteroid therapy in patients with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome: impact on the rate of regional anesthesia.

Abstract：

OBJECTIVE:Our purpose was to assess the impact of glucocorticoid administration on the rate of regional anesthesia in women with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. STUDY DESIGN:Maternal records of pregnancies with HELLP syndrome managed between April 1994 and December 1999 were analyzed retrospectively. RESULTS:Sixty-nine patients were identified with antepartum HELLP syndrome and 46 (66%) received glucocorticoids. The presence of thrombocytopenia at admission and the interval from presentation to delivery was evaluated to assess the impact of glucocorticoid use. In the 37 women who had platelet counts of <90,000/mm3, 0 in the untreated group (0 of 11) versus 42% in the steroid group (11 of 26) received regional anesthetic, P =.015. Furthermore, the rate of regional anesthesia increased from 0 in the untreated group delivered within 24 hours (n = 10) to 57% (8 of 14) in the glucocorticoid group, in which women attained a 24-hour latency from presentation to delivery, P =.006. The need for general anesthesia also decreased significantly in treated women who attained a 24-hour latency compared to untreated women who did not, 100% (n = 7) versus 22% (n = 9), P =.003. CONCLUSIONS:Administration of glucocorticoids increases the use of regional anesthesia in women with antepartum HELLP syndrome who have thrombocytopenia, particularly in those who achieve a latency of 24 hours before delivery.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

O'Brien JM,Shumate SA,Satchwell SL,Milligan DA,Barton JR

doi

10.1067/mob.2002.121074

subject

Has Abstract

pub_date

2002-03-01 00:00:00

pages

475-9

issue

3

eissn

0002-9378

issn

1097-6868

pii

S0002937802905788

journal_volume

186

pub_type

杂志文章

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