There was no clear evidence of any effect of corticosteroids on substantive clinical outcomes. Those receiving steroids showed significantly greater improvement in platelet counts which was greater for those receiving dexamethasone than those receiving betamethasone. There is to date insufficient evidence of benefits in terms of substantive clinical outcomes to support the routine use of steroids for the management of HELLP. The use of corticosteroids may be justified in clinical situations in which increased rate of recovery in platelet count is considered clinically worthwhile.
Dexamethasone in the post-partum treatment of HELLP syndrome.
To determine if the routine initiation of dexamethasone in patients with post-partum HELLP syndrome produces therapeutic benefits.
                The puerperal courses of 17 mothers who initially received dexamethasone after delivery were compared to 17 other mothers with HELLP syndrome who received no corticosteroids during the puerperium course. Treated patients immediately received 10 mg of dexamethasone post-partum (intravenously) followed 12 h later by 10 mg and 10 mg at 24 h post-partum, to a total of 30 mg.
                The steroid treated group had significant changes over time in platelet count. Relative to the control group the platelet count increased significantly by 30 h post-partum (P < 0.01). The blood pressure, urinary output, lactic dehydrogenase, aspartato aminotransferase and alanine aminotransferase values were not significantly different between the dexamethasone and control group at any time by 72 h post-partum.
                Parturients with HELLP syndrome who received a short course of post-partum dexamethasone therapy had an accelerated recovery from their platelet count, but not from their liver enzymes and blood pressure.