■HELLP综合征,以溶血为特征,肝酶升高,和血小板减少症,是危及生命的妊娠疾病,会引发孕妇和胎儿/新生儿的合并症。这项研究提供了相关研究的最新系统评价和荟萃分析,以评估皮质类固醇在母婴结局中的治疗效果。
■关于在HELLP人群中使用皮质类固醇的随机对照试验(RCT)来自三个电子数据库,包括OvidMEDLINE,OvidEmbase,和Cochrane中央控制试验登记册,从数据库开始到202323年3月23日,2023年3月23日。
■总共从7个随机对照试验中纳入了485例接受皮质类固醇治疗的患者。与安慰剂相比,皮质类固醇治疗未能显著改善产妇发病率方面的产妇结局(RR=1.36,95CI[0.45,4.10]),子痫(RR=1.16,95CI[0.76,1.77]),急性肾功能衰竭(RR=0.71,95CI[0.41,1.22]),肺水肿(RR=0.34,95CI[0.10,1.15])和少尿(RR=1.08,95CI[0.75,1.54])。此外,汇总数据显示,在新生儿结局方面,糖皮质激素治疗和安慰剂治疗之间没有显著差异.
■这项研究比较了糖皮质激素在HELLP综合征患者中的疗效,提示皮质类固醇对HELLP孕妇和新生儿的临床结局无显著益处.这项研究的结论必须通过更大的高质量随机对照试验样本来验证。
UNASSIGNED: HELLP syndrome, featuring hemolysis, elevated liver enzymes, and thrombocytopenia, is life-threatening disease of pregnancy that triggers comorbidities in both pregnant women and the fetus/newborn. This study provides an updated systematic review and meta-analysis of relevant studies to assess the therapeutic efficacy of corticosteroids in maternal and neonatal outcomes.
UNASSIGNED: Randomized control trials (RCTs) regarding the use of corticosteroids in the
HELLP population from three electronic databases, including Ovid MEDLINE, Ovid EMBASE, andCochrane Central Register of Controlled Trials, were searched from database inception to 23 March 202323 March 2023.
UNASSIGNED: A total of 485 patients treated with corticosteroids from 7 RCTs were included. Compared to placebo, corticosteroids therapy failed to significantly improve the maternal outcomes regard to maternal morbidity (RR = 1.36, 95%CI [0.45, 4.10]), eclampsia (RR = 1.16, 95%CI [0.76, 1.77]), acute renal failure (RR = 0.71, 95%CI [0.41, 1.22]), pulmonary edema (RR = 0.34, 95%CI [0.10, 1.15]) and oliguria (RR = 1.08, 95%CI [0.75, 1.54]). In addition, pooled data showed that it wasn\'t significant differences between corticosteroids therapy and placebo regarding neonatal outcomes.
UNASSIGNED: This study compared the efficacy of corticosteroids in patients with
HELLP syndrome, revealing that corticosteroids did not provide any significant benefit in clinical outcomes for pregnant women and newborns with
HELLP. The conclusions of this study must be verified by a larger sample of high-quality RCTs.