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IV Dexamethasone Speeds Recovery From HELLP.
CHICAGO -- Intravenous dexamethasone provides more rapid recovery of liver function, arterial blood pressure, and urinary output in patients with prepartum HELLP syndrome, compared with betamethasone, Dr. Christy M. Isler said at the annual meeting of the Central Association of Obstetricians and Gynecologists.
About 1 in 10 patients with preeclampsia develop HELLP syndrome, characterized by hemolysis, elevated liver enzymes, and low platelet counts.
While still largely controversial, intravenous dexamethasone has been the standard treatment of HELLP syndrome at the University of Mississippi Medical Center, Jackson, while intramuscular betamethasone has been a standard therapy given to hasten fetal lung maturation. The investigators' hope in conducting the study was that if betamethasone were shown to be as effective as dexamethasone for treating HELLP, the number of agents to which patients were exposed would be decreased because they wouldn't need the dexamethasone, Dr. Isler explained in an interview.
In the study, 40 patients with class I or II HELLP syndrome were randomly assigned to receive dexamethasone, 10 mg IV every 12 hours, or betamethasone, 12 mg IM every 24 hours, until they achieved symptom resolution, stabilization of a blood pressure less than 160 / 110 mm Hg, and a urinary output of at least 50 cc/hr. Both groups were treated for a mean of 20 hours.
The 19 patients in the dexamethasone group had significantly more rapid improvement in aspartate aminotransferase levels, indicating better liver function, compared with the 21 patients in the betamethasone group.
And compared with baseline values, dexamethasone was associated with a significantly quicker time-averaged drop in arterial pressure (-15.6 mm Hg), compared with betamethasone (-8.1 mm Hg).
The time-averaged change in urinary output, compared with baseline, was also significantly better in the dexamethasone group (13 cc/hr) than in the betamethasone group (-12 cc/hr). Additionally patients in the ...
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Source: HighBeam Research, IV Dexamethasone Speeds Recovery From HELLP.