Corticosteroids, pregnancy, and HELLP syndrome: a review

Obstet Gynecol Surv. 2005 Jan;60(1):57-70; quiz 73-4. doi: 10.1097/01.ogx.0000150346.42901.07.

Abstract

Corticosteroids are potent antiinflammatory and immunosuppressive drugs, which are used in the treatment of a wide range of medical disorders. During pregnancy, several corticosteroids are administered for maternal as well as fetal reasons. Prednisone and prednisolone show limited transplacental passage and are thus used for treatment of maternal disease. Dexamethasone and betamethasone, drugs that can easily cross the placenta, are more suitable for fetal indications. During the last decade, administration of corticosteroids was introduced in the treatment of hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome), a severe form of preeclampsia unique to human pregnancy. Several randomized, controlled trials as well as other prospective and retrospective studies have been performed to investigate this beneficial effect of corticosteroids on biochemical measures and clinical signs. This review discusses the characteristics of corticosteroids in humans and details the use of corticosteroids during pregnancy. A review of literature on the effect of corticosteroids on HELLP syndrome is given and possible mechanisms of action are discussed.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / pharmacokinetics
  • Adrenal Cortex Hormones / pharmacology
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Female
  • HELLP Syndrome / drug therapy*
  • Humans
  • Maternal-Fetal Exchange
  • Pregnancy
  • Randomized Controlled Trials as Topic

Substances

  • Adrenal Cortex Hormones