Vázquez-Rodríguez JG, Servín-Hernández CA, Méndez-Vale OJ

Language: Spanish
References: 0
Page: 345-353
PDF size: 326.20 Kb.

ABSTRACT

Background: Increase in platelet count due to the effect of dexamethasone in HELLP syndrome can vary according to the dose used.
Objetive: To compare of the effect of a low-dose vs. high-dose of dexamethasone on clinical outcome, biochemical test and platelet count of patients with HELLP syndrome.
Material and Methods: We carried out an observational, longitudinal, retrospective, comparative and analytical study in patients with HELLP syndrome. From admission until the third postpartum day, intravenous dexamethasone was administered as follows: group A received a low-dose (10 mg/12 h) and group B received a high-dose (32 mg initially followed by 8 mg/8 h). We compared prepartum platelet count (basal) and the first to sixth day postpartum, as well as arterial pressure, liver enzymes, total bilirubin, glycemia and intensive care stay. Descriptive statistics and Student t-test were used for statistical analyses.
Results: We registered 197 patients: 77 in group A, and 120 in group B. Platelet count in group A improved significantly (basal 110,259 ± 29,663 vs. the sixth day 194,000 ± 70,200 platelets/µL, p=0.04) but not for group B (basal 107,706 ± 46,343 vs the sixth day 148,250 ± 33,340 platelets/µL (p=0.09). The comparison did not show differences (basal p=0.10, sixth day p=0.35). Increase in platelets in group A was noticeable on the third day. No differences were shown in group B for the same day (p=0.83). Clinical, hemodynamic and biochemical parameters and length of stay were similar.
Conclusion: Both schemes improved platelet count with more evidence in group A. No findings indicated a preference for either scheme.