Hellp sendromlu hastalarda antepartum kortikosteroid kullanımının prognoza etkisi
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2004
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info:eu-repo/semantics/openAccess
Özet
Amaç : HELLP sendromlu hastalarda; antenatal dönemde verilen yüksek doz steroid tedavisinde deksametazon ve betametazonun etkinliklerinin karşılaştırılması Materyal ve Metod : Çalışma grubu HELLP sendromu tanısı olan 24-41 gebelik haftaları arası 88 gebeden oluşmaktaydı.Çalışma grubu 3 gruba ayrıldı İlk grup deksametazon tedavisi alan 38,ikinci grup betametazon tedavisi alan 25 ve üçüncü grup herhangi bir steroid tedavisi almayan 25 hastadan oluştu. Birinci gruba tedricen azaltılmak üzere, 4 günde, toplam 30mg intravenöz deksametazon, ikinci gruba fetal pulmoner maturitenin sağlanması amacıyla standart doz intramüsküler betametazon verildi. Üçüncü gruba steroid verilmedi Hastalar kan basıncı, idrar çıkışı, trombosit sayısı ve karaciğer fonksiyonları yönünden (AST, ALT, LDH) izlendiler Bulgular: Her üç grubun bazal demografik ve labaratuvar değerleri benzer olmasına rağmen, trombosit sayısı, karaciğer fonksiyon testleri, kan basıncı, idrar çıkışı düzelme zamanı deksametazon alan grupta daha kısa idi. Yine ilk grupta kan transfüzyonu gerekliliği ve postpartum hastanede kalış süresi azalmıştı. AST, ALT, LDH düzelmesi dışındaki değerler istatistiksel olarak da anlamlı idi. Sonuç: Bu çalışma HELLP sendromlu hastalarda antenatal dönemde intravenöz deksametazon tedavisinin hematolojik paramatrelerde ve klinik süreçte belirgin bir düzelmeye yol açtığını göstermektedir.Bu yüzden bu tedavinin, hastalığın kontrol altına alınmasında etkili bir tedavi rejimi olabileceğini desteklemektedir.
Objective: The purpose of this study was to compare the effects of dexamethasone and betamethasone given for the high dose antepartum steroid treatment of HELLP syndrome. Material and Method: The study group consisted of 88 HELLP syndrome patients between 24-41 weeks of gestational age The study group was divided into 3 groups.In the first group,thirty-eight pregnant women were randomized to receive intravenously dexamethasone treatment for a total dose of 30 mg which was given in temporating doses and ceased within a four day period. For the second group, 25 pregnant women were given standard dose of betamethasone for fetal pulmoner maturation. In the third group, 25 patients, didn't take any steroid treatment. Efficiacy of treatment was evaluated by clinical parameters (mean arterial pressure, urinary output) and laboratory values (platelet counts, LDH, AST, ALT levels). Results: Although the basal demographic and laboratory parameters of three groups were similar, remisson time were shorter than the others in the dexamethasone group according to platelet counts, AST, ALT, LDH levels, mean arteriel tension, urinary output. For dexamethasone group duration of hospitalization in the postpartum period was shorter and also the need for transfusion of blood pruducts was lesser compared to the other groups. The values other than the levels of ALT, AST,LDH were also statistically significant. Conclussion : This study demonstrates that antenatal administration of intravenous dexamethasone in HELLP Syndrome patients leads to a significant improvement in hematologic parameters and clinical outcome so,it may be an efficiant and beneficial treatment modality in the management of the disease.
Objective: The purpose of this study was to compare the effects of dexamethasone and betamethasone given for the high dose antepartum steroid treatment of HELLP syndrome. Material and Method: The study group consisted of 88 HELLP syndrome patients between 24-41 weeks of gestational age The study group was divided into 3 groups.In the first group,thirty-eight pregnant women were randomized to receive intravenously dexamethasone treatment for a total dose of 30 mg which was given in temporating doses and ceased within a four day period. For the second group, 25 pregnant women were given standard dose of betamethasone for fetal pulmoner maturation. In the third group, 25 patients, didn't take any steroid treatment. Efficiacy of treatment was evaluated by clinical parameters (mean arterial pressure, urinary output) and laboratory values (platelet counts, LDH, AST, ALT levels). Results: Although the basal demographic and laboratory parameters of three groups were similar, remisson time were shorter than the others in the dexamethasone group according to platelet counts, AST, ALT, LDH levels, mean arteriel tension, urinary output. For dexamethasone group duration of hospitalization in the postpartum period was shorter and also the need for transfusion of blood pruducts was lesser compared to the other groups. The values other than the levels of ALT, AST,LDH were also statistically significant. Conclussion : This study demonstrates that antenatal administration of intravenous dexamethasone in HELLP Syndrome patients leads to a significant improvement in hematologic parameters and clinical outcome so,it may be an efficiant and beneficial treatment modality in the management of the disease.
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