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In a young woman a twin pregnancy and uneventful labour were complicated by the development of the postpartum haemolytic-uraemic syndrome. A number of unusual features of this syndrome were present, including early onset, accompanying hepatocellular necrosis, hepatic encephalopathy and bleeding diathesis. Early institution of heparin therapy combined with coagulation factor replacement was followed by cessation of haemorrhage and complete recovery from acute renal failure.

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