Postpartum thrombotic microangiopathic syndrome.

Abstract

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.

• Authors: Michelle Y Owens, James N Martin Jr, Kedra Wallace, Sharon D Keiser, Marc R Parrish, Kiran B Tam Tam, Rick W Martin
• Journal: Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis (Transfus Apher Sci) Vol. 48 Issue 1 Pg. 51-7 (Feb 2013) ISSN: 1473-0502 [Print] England
• PMID: 22704633 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Ltd. All rights reserved.

Topics

• Adult
• Female
• HELLP Syndrome (blood, therapy)
• Humans
• Middle Aged
• Plasma Exchange (methods)
• Postpartum Period
• Pregnancy
• Retrospective Studies
• Survival Analysis