Primary prevention

Low-dose aspirin might prevent or delay the onset of pre-eclampsia, including HELLP syndrome.[45][46]​ The putative protective effect of low-dose aspirin for the prevention of pre-eclampsia has been investigated in many trials in different populations. The results of the most recent trials, including more than 30,000 women, revealed small-to-moderate reduction in the relative risk of pre-eclampsia and its complications.[47] [ Cochrane Clinical Answers logo ] Guidelines recommend women with risk factors for pre-eclampsia should, therefore, take low-dose aspirin from 12 to 16 weeks of pregnancy until the birth of the baby.[8][48]

Randomised trials of magnesium, zinc, vitamin C, vitamin E, or fish oil supplementation have demonstrated no benefit.[49][50]

Inherited thrombophilias have not been established as a cause of placenta-mediated pregnancy complications, including pre-eclampsia, and anticoagulation of patients with an inherited thrombophilia to prevent pre-eclampsia is not recommended outside clinical trials.[51]

Early detection and aggressive management with intravenous dexamethasone and intravenous magnesium sulfate, and rigorous blood pressure control with prevention of severe systolic hypertension, presently is the safest, most likely way to reduce the adverse maternal outcomes.[30][52][53] In a Mississippi series of 190 patients managed in this way, there were no reports of stroke, liver rupture, or maternal death.[53]

Secondary prevention

Currently, there is no effective intervention to prevent the recurrence of HELLP syndrome.

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