Postpartum thrombotic microangiopathic syndrome

Transfus Apher Sci. 2013 Feb;48(1):51-7. doi: 10.1016/j.transci.2012.05.016. Epub 2012 Jun 14.


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.

MeSH terms

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