Postpartum thrombotic microangiopathic syndrome

ObjectiveCharacterization 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 designPatients 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.ResultsNine 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).ConclusionNineteen patients from publications combined with our patients suggest five categories of postpartum thrombotic microangiopathy syndrome that exhibit HELLP syndrome criteria and respond to PPEX.