Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Barthel, C.
Exertion of a combined therapeutical concept: Influence on pregnancy outcome and clinical parameters in HELLP patients
Humanmedizin; [ Diplomarbeit/Master Thesis (UNI) ] Graz Medical University; 2015. pp.72.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Cervar-Zivkovic Mila
- Lakovschek Ioana-Claudia
- Altmetrics:
- Abstract:
- Introduction: The syndrome of hemolysis, elevated liver enzymes and low platelets is a severe complication of pregnancy. It is associated with a higher risk of complications in mother and child, and effective ways for conservative management are yet to be developed. Glucocorticoids have been claimed to be beneficial in HELLP patients for pregnancy outcome and disease course. Also, administration of magnesium sulfate showed a positive effect on prophylaxis of eclamptic seizures. Glucocorticoids and magnesium application are therefore part of our combined therapeutical concept for HELLP syndrome, and their effects have been evaluated in this study. Methods: From the years 2005 until 2013 the effect of high dose prednisolone on maternal and neonatal outcome in HELLP syndrome was analyzed in a retrospective study. Data was presented in absolute numbers and percentages. Statistical analysis was performed using Chi square, Fisher’s exact test, independent T test and ANOVA calculation. A two-sided p-value of less than 0.05 was considered as significant. Results: Pregnancies complicated by HELLP syndrome (n=80) were divided in 3 groups: PRED receiving high-dose prednisolone administered one to three times (n=50, 62.5%) MIX received more than three doses and different types of corticosteroids (n= 12, 15%) NO, receiving no corticosteroids (n=18, 22.5%) \end{quote} There is a tendency to shorter intensive care and hospitalization time, decreased incidence of cesarean section, and increased ratio of completion of lung maturation in PRED group. Independently from these groups, the cohort was distributed into Mg and NoMg groups. Mg group Patients with intravenous magnesiumsulfate infusion NoMg groupPatients without intravenous magnesiumsulfate infusion The rate of occured eclampsia and neurological deficiency was determined within these groups. We found a tendency of decreased occurance of eclampsia and can assert that magnesium sulfate infusion is beneficial for HELLP patients. Conclusion: We confirmed that magnesium sulfate has a positive effect on eclampsia rates. Therefore it is an important asset in the therapeutical management of HELLP syndrome. Although no significant results were found, high-dose prednesolone application seems to be beneficial for complication rate and course of disease in HELLP patients. Conservative management with this combined therapeutical concept should be performed at a maximum care facility. Bigger prospective studies must follow to further evaluate high-dose corticosteroid administration in HELLP patients.