Ozer Alev, Kanat-Pektas Mine, Ozer Serdar, Tapisiz Omer Lutfi, Zulfikaroglu Ebru Emine, Danisman Nuri
Department of Perinatology, Dr. Zekai Tahir Burak Women Health Research and Education Hospital, Ankara, Turkey.
Arch Gynecol Obstet. 2009 Jul;280(1):65-70. doi: 10.1007/s00404-008-0865-3. Epub 2008 Dec 14.
The present study aims to investigate the effects of betamethasone treatment on clinical outcome and laboratory data of pregnant women diagnosed with HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome.
A prospective, randomized and placebo-controlled clinical trial was undertaken in a total of 60 pregnant women with HELLP syndrome who were treated at the perinatology department of the study center between January 2005 and February 2008. Betamethasone treatment (intramuscular injection of 12 mg in every 24 h) was given to 30 subjects while remaining 30 subjects received placebo. The treatment and control groups were compared in the aspects of clinical outcome and laboratory data.
The alterations in platelet counts, alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase levels of women treated with betamethasone were statistically similar to those of the placebo group. Although there was a significant decrease in diastolic blood pressure values of control group (P = 0.04), alterations in systolic blood pressure values were statistically indifferent in both study groups. Hematological and metabolic complications occurred significantly less in women treated with betamethasone (P < 0.05). Interestingly, the percentage of women who received platelet transfusion was significantly higher in the control group (P < 0.005). No case of maternal mortality occurred.
The betamethasone treatment has ended up with insignificant alterations in clinical outcomes and laboratory data of women with HELLP syndrome except beneficial effects on metabolic complications and need for platelet transfusion. Further investigation is required to assess the efficiency of betamethasone in management of HELLP syndrome.
本研究旨在探讨倍他米松治疗对诊断为HELLP（溶血、肝酶升高和血小板计数降低）综合征的孕妇临床结局及实验室数据的影响。
2005年1月至2008年2月期间，在研究中心围产医学科对总共60例患有HELLP综合征的孕妇进行了一项前瞻性、随机、安慰剂对照临床试验。30名受试者接受倍他米松治疗（每24小时肌肉注射12毫克），其余30名受试者接受安慰剂治疗。比较治疗组和对照组在临床结局和实验室数据方面的情况。
接受倍他米松治疗的女性血小板计数、丙氨酸转氨酶、天冬氨酸转氨酶和乳酸脱氢酶水平的变化与安慰剂组在统计学上相似。虽然对照组舒张压值有显著下降（P = 0.04），但两个研究组收缩压值的变化在统计学上无差异。接受倍他米松治疗的女性血液学和代谢并发症显著较少（P < 0.05）。有趣的是，对照组接受血小板输注的女性比例显著更高（P < 0.005）。未发生孕产妇死亡病例。
倍他米松治疗对HELLP综合征女性的临床结局和实验室数据的改变不显著，但对代谢并发症和血小板输注需求有有益影响。需要进一步研究以评估倍他米松在治疗HELLP综合征中的疗效。
