A 32-year-old woman with known HELLP syndrome at 30 weeks is given dexamethasone 10 mg IV twice daily to accelerate fetal lung maturity. After 48 hours, her platelet count drops further from 52,000 to 38,000/µL and LDH rises. Which statement best describes the role of antenatal corticosteroids in maternal HELLP syndrome?

• A Corticosteroids are contraindicated as they worsen thrombocytopenia and increase bleeding risk
• B Corticosteroids transiently improve platelet counts and liver enzymes, but definitive treatment remains delivery ✓
• C Corticosteroids are the primary definitive therapy and delivery can be delayed until counts normalize
• D Corticosteroids improve fetal lung maturity and also reverse maternal HELLP in over 70% of cases

Explanation

Antenatal corticosteroids (dexamethasone) can transiently improve platelet counts and liver enzymes in HELLP syndrome, which may allow a brief window to administer steroids for fetal lung maturity. However, they are NOT definitive therapy. Delivery remains the only cure, and expectant management beyond 48 hours is generally not recommended in severe HELLP before 34 weeks. Corticosteroids do not reverse HELLP definitively in the majority.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.