Controversial clinical practices for patients with preeclampsia or HELLP syndrome: a survey

J Perinat Med. 2015 Jan;43(1):61-6. doi: 10.1515/jpm-2014-0109.

Abstract

Background: Considerable controversy continues to surround the management of severe preeclampsia and HELLP syndrome. Experts, researchers, and those published in the field were surveyed about their specific practices.

Materials and methods: An extensive literature search was undertaken to identify the cohort of authors with recent publications on the subjects of preeclampsia (2009-2012) and HELLP syndrome (2005-2012). Online surveys were sent to all authors using the email addresses found in their publications.

Results: Surveys were delivered by email to 363 authors of preeclampsia publications and 91 authors of HELLP syndrome publications. Completed surveys were received from 61 (13.4%) of the group. Except for consensus about the indication of corticosteroids for the enhancement of fetal lung maturation, there was considerable variation in corticosteroid practice and anesthesia techniques.

Conclusions: A marked diversity in practice characterized the clinical care rendered by experts in the field of preeclampsia and HELLP syndrome. Thus, there is an urgent need for well-designed and executed prospective clinical trials to improve the evidence for best consensus practice in this area of obstetrical medicine.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anesthesia
  • Female
  • HELLP Syndrome / therapy*
  • Humans
  • Practice Patterns, Physicians' / statistics & numerical data
  • Pre-Eclampsia / therapy*
  • Pregnancy
  • Surveys and Questionnaires

Substances

  • Adrenal Cortex Hormones