Objective: To evaluate the effect of corticosteroid treatment on the postpartum recovery of parturients with HELLP syndrome. Method: Thirty cases with HELLP syndrome were randomly assigned to a study or a control group, each including 15 patients. A total dose of 30 mg intravenous dexamethasone was given to the study group during the 36 h following the childbirth, while the control group did not receive any steroid medication. Arterial blood pressure, urine output, hematocrit ratio, platelet count, serum alanine and aspartate aminotransferases and uric acid levels were monitored during the first 48 h postpartum. The data were analyzed by unpaired t-test, chi(2) or Fisher's exact tests. Result: Before the treatment, no significant difference was observed between the two groups. The study group showed statistically significant improvement in mean arterial blood pressure, mean serum aspartate aminotransferase level, mean urine volume per hour and mean platelet count (P < 0.05). Length of hospitalization was also shorter in the study group (P < 0.01). Conclusion: Early postpartum high-dose corticosteroid treatment accelerates the recovery and shortens the hospitalization of the parturients with HELLP syndrome. (C) 1998 International Federation of Gynecology and Obstetrics.