Background: Haemolysis, elevated liver enzymes, and low platelet (HELLP) syndrome is a severe form of preeclampsia. It is often manifested clinically by elevated blood pressure, proteinuria and abdominal pain. Women diagnosed with the HELLP-syndrome normally show evidence of recovery within the first 48 hours after delivery. There is however a small group of patients in which no arrest or reversal of the HELLP process can be seen after 72 hours post partum. These patients have a high incidence of maternal morbidity and mortality. Several studies have shown benefits to HELLP patients after administration of corticosteroids.
Material and methods: We have reviewed the literature for this treatment and present a case report as illustration. PubMed/Medline was searched with the key words "HELLP and corticosteroids" from 1990 to 2006. We have chosen to review the prospective and randomised studies.
Results and interpretation: None of the studies show statistically significant differences in maternal morbidity or mortality by administering corticosteroids to patients with HELLP syndrome. Treatment can give a faster increase in the platelet count for patients with platelets < 50 (10(9)/L), but larger trials are needed to support the use of corticosteroids for treatment of HELLP-syndrome.