Successful pregnancy in a patient with hemolytic-uremic syndrome during the second trimester of pregnancy
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S Martínez-Román1, E Gratacós, A Torné
1Department of Obstetrics and Gynecology, Hospital Clinic, University of Barcelona, Spain.
Background:
Hemolytic uremic syndrome (HUS) is a rare, well-characterized complication of the puerperium constituting a cause of acute renal failure after an uncomplicated delivery. However, its presentation during pregnancy is unusual, with only four cases before the 20th week of gestation reported.
Case:
A case of HUS occurred at 18 weeks' gestation. Despite the initial severity of the clinical presentation, therapy, consisting of corticosteroids and plasmapheresis, resulted in complete recovery of renal function, with a rapid improvement in thrombocytopenia and hemolysis. No remarkable events occurred after this episode, and a full-term pregnancy with a normal fetal outcome was achieved.
Conclusion:
We are aware of no other reports of successful pregnancy after the development of HUS during the first half of pregnancy. This provides evidence that continuation of pregnancy until term is possible. Rapid diagnosis and intensive treatment with plamapheresis, corticosteroids and dialysis, when required, may improve the maternal and fetal prognosis.