HELLP syndrome is a disorder associated with serious maternal morbidity and mortality.
Distinguishing HELLP from other pregnancy-related disorders is often challenging and may result in
delay of treatment. Differential diagnoses include acute fatty liver of pregnancy, thrombotic thrombocytopenic
purpura, antiphospholipid syndrome, and hemolytic uremic syndrome, and are reviewed in
this chapter. While there is not any current treatment for HELLP, the mainstay of treatment involves
maternal stabilization and timely delivery. Various treatment strategies have been attempted to help
decrease the morbidity and mortality of HELLP, including the maternal use of corticosteroids. The
authors review the studies and controversies surrounding the maternal use of corticosteroids, plasma
exchange, and low molecular weight heparin for the treatment of HELLP, as well as the role of the
complement system in HELLP. Further large, well-designed, randomized controlled trials are needed
to address the role corticosteroids may play in the treatment of women with HELLP and to help improve
maternal and fetal outcomes.
Keywords: HELLP syndrome, hypertension, corticosteroids, thrombocytopenia, preeclampsia, complement.
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