Standardized Mississippi Protocol Treatment of 190 Patients with HELLP Syndrome: Slowing Disease Progression and Preventing New Major Maternal Morbidity

James N. Martin Jr.Division of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USACorrespondence[email protected]

, MD,

Michelle Y. OwensDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USA

, MD, MS,

Sharon D. KeiserDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USA

, MD, MS,

Marc R. ParrishDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USA

, DO,

Kiran B. Tam TamDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USA

, MD,

Justin M. BrewerDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USA

, MD,

Julie L. CushmanDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USA

, RN &

Warren L. MayDivision of Maternal–Fetal Medicine, Department of Obstetrics and Gynecology, and the Biostatistics Center, University of Mississippi Medical Center, Jackson, MS, USA

, PhD show all

Abstract

Objective. To evaluate the effectiveness of the Mississippi Protocol (MP) to treat HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. Methods. Uniform early initiation of MP (corticosteroids, magnesium sulfate, systolic blood pressure control) was studied prospectively in patients admitted with severe preeclampsia/class 1 or class 2 HELLP syndrome. Results. One hundred and ninety patients between 2000 and 2007 received MP without suffering maternal death, stroke, or liver rupture. Only 39 of 163 patients (24%) not class 1 when MP began progressed to class 1 disease; only 18.2% of class 1 and 2.4% of class 2 subsequently developed major maternal morbidity. Conclusion. Early initiation of MP inhibits HELLP syndrome disease progression and severity.

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Standardized Mississippi Protocol Treatment of 190 Patients with HELLP Syndrome: Slowing Disease Progression and Preventing New Major Maternal Morbidity

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Standardized Mississippi Protocol Treatment of 190 Patients with HELLP Syndrome: Slowing Disease Progression and Preventing New Major Maternal Morbidity

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