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Published on: June 4, 2021
Postpartum thrombotic microangiopathic syndrome
Michelle Y Owens1, James N Martin, Kedra Wallace
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Winfred L. Wiser Hospital for Women and Infants, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States. myowens@umc.edu
Objective:
Characterization of syndromes for patients with life-threatening, progressively worsening hemolysis-elevated-liver-enzymes-and-platelet (HELLP) syndrome-like diseases and with thrombotic microangiopathies. RETROSPECTIVE STUDY DESIGN: Patients who underwent postpartum plasma-exchange (PPEX) for preeclampsia-related, and microangiopathy/coagulopathy illnesses unresponsive to medical therapy between 1994 and 2008 in our center and elsewhere.
Results:
Nine patients were treated with PPEX in our center with 78% maternal survival. Treatment with PPEX increased platelet levels (p=0.048), decreased serum lactic dehydrogenase (p=0.0012) and aspartate aminotransferase (p=0.0001).
Conclusion:
Nineteen patients from publications combined with our patients suggest five categories of postpartum thrombotic microangiopathy syndrome that exhibit HELLP syndrome criteria and respond to PPEX.
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