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It is worthwhile to review the milestones through which we have passed internationally in obstetrics as the peril that this disorder poses to pregnancy has been exposed. Factors of importance for emphasis will be definitions, reasons why the triple classification system impacts practice, the important role glucocorticoids have in reversing the pathogenesis of the disorder if used early, the excellent results reported for mothers when all components of the Mississippi Protocol are utilized for patient care, and the place of plasma exchange in special situations. Our challenge for the future is to delay or prevent HELLP's development prior to potential viability so that stillbirths and very preterm losses can be reduced or eliminated.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2013.02.001","type":"journal-article","created":{"date-parts":[[2013,3,23]],"date-time":"2013-03-23T01:49:58Z","timestamp":1364003398000},"page":"202-207","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":37,"title":["Milestones in the quest for best management of patients with HELLP syndrome (microangiopathic hemolytic anemia, hepatic dysfunction, thrombocytopenia)"],"prefix":"10.1002","volume":"121","author":[{"suffix":"Jr.","given":"James Nello","family":"Martin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3,23]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2009.02.010"},{"issue":"2","key":"e_1_2_2_3_2","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0002-9378(16)32330-4","article-title":"Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy","volume":"142","author":"Weinstein L.","year":"1982","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(86)90266-8"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(93)90043-I"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199011000-00001"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(91)91429-Z"},{"key":"e_1_2_2_8_2","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S0002-9378(12)90962-X","article-title":"Analysis of 454 pregnancies with severe preeclampsia\/eclampsia HELLP syndrome using the 3\u2010class system of classification","volume":"168","author":"Martin J.N.","year":"1993","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(99)70022-0"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1993.tb02374.x"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1993.tb02375.x"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90054-X"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90055-8"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920090303"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)91470-6"},{"key":"e_1_2_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000215994.25958.31"},{"key":"e_1_2_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2012.05.016"},{"key":"e_1_2_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70162-X"},{"key":"e_1_2_2_19_2","unstructured":"Martin JN Jr Brewer JM Blake PG Sunesara IR Canizaro A Wallace KW et al.HELLP syndrome and composite major maternal morbidity: importance of Mississippi Classification System. 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