For years, immediate delivery in HELLP syndrome was the only treatment option. The main problem is the iatrogen-related preterm childbirth. In this retrospective study it was investigated whether a prolongation with perinatal methylprednisolone therapy has an advantage on the maternal and neonatal state. 138 cases (1990-2013) from the University Hospitals Halle and Magdeburg were analyzed. Median could be achieved a prolongation period of 4d (1-55d). The maternal laboratory values improved faster with Urbason. Maternal and neonatal complications occurred less frequently. The children were always delivered after prolongation with a higher birth weight and more stable general condition. They demonstrated a lower risk of ventilation regardless. Ventilation and length of stay on the intensive care unit were shorter. In conclusion, however, it has been shown that the severity of HELLP symptoms does not determine the neonatal outcome, but the degree of prematurity.