Postpartum thrombotic microangiopathic syndrome.
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).


CONCLUSIONS
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.
Division 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
Michelle Y
MY
Owens
James N
JN
Martin
Kedra
K
Wallace
Sharon D
SD
Keiser
Marc R
MR
Parrish
Kiran B
KB
Tam Tam
Rick W
RW
Martin
D000328:Adult; D005260:Female; D017359:HELLP Syndrome / Q000097:blood / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D010951:Plasma Exchange / Q000379:methods*; D049590:Postpartum Period; D011247:Pregnancy; D012189:Retrospective Studies; D016019:Survival Analysis