Dexamethasone Efficacy in HELLP I Syndrome

• Recovery time of platelets to more than 100000/mm3 [ Time Frame: Average:7 days ] [ Designated as safety issue: No ]
• Recovery of AST, ALT and LDH [ Time Frame: Average: 10 days ] [ Designated as safety issue: No ]
• Transfusion of blood products [ Time Frame: Average: 7 days ] [ Designated as safety issue: No ]

The purpose of this study is to determine the efficacy of dexamethasone for treatment of HELLP I (hemolysis, elevated liver enzymes and low platelet count) syndrome.

Treatment of HELLP syndrome usually is restricted to measures of support and treatment of complications. In 2005, in a subgroup analysis we showed that, among patients with HELLP 1, there were a shorter average time to platelet recovery and less duration of hospitalization in women who received dexamethasone therapy, however the importance of this finding is diminished because this was an unplanned analysis and the severity of the disease was not taken into account at randomization.

• Drug: Dexamethasone
  Pregnant women in the experimental group will receive 10-mg doses (2.5 cc) of dexamethasone sodium phosphate intravenously every 12 hours until delivery and 3 additional doses after delivery. Puerperal women will receive 3 10-mg doses after delivery.
  Other Name: steroid ev
• Drug: sterile water
  Pregnant women will receive 2.5 cc of sterile water every 12 hours until delivery and 3 additional doses after delivery. Puerperal women will receive 3 doses after delivery
  Other Name: sterile water

• Placebo Comparator: sterile water
  Pregnant women will receive 2.5 cc of sterile water every 12 hours until delivery and 3 additional doses after delivery. Puerperal women will receive 3 doses after delivery.
  Intervention: Drug: sterile water
• Experimental: Dexamethasone
  Pregnant women in the experimental group will receive 10-mg doses (2.5 cc) of dexamethasone sodium phosphate intravenously every 12 hours until delivery and 3 additional doses after delivery. Puerperal women will receive 3 10-mg doses after delivery.
  Intervention: Drug: Dexamethasone

Inclusion Criteria:

• Women who were at >20 weeks of gestation or during the first 3 days of puerperium if hypertension developed during the pregnancy or the puerperium with:
• platelet count, < or = 50,000/mm3; aspartate aminotransferase (AST), > or = 70 U/L; lactate dehydrogenase (LDH), > or = 600 U/L.
• Women who consent to be included informed consent by signature

Exclusion Criteria:

• diabetic ketoacidosis
• oral temperature > 37.5 grade
• Contraindication for use steroids