Role of plasma exchange in postpartum microangiopathies: An experience from a tertiary care center

• Main Authors: Rekha Hans, Satya Prakash, Divjot Singh Lamba, Ratti Ram Sharma, Pankaj Malhotra, Vanita Suri, Neelam Marwaha
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Asian Journal of Transfusion Science
• Subjects: microangiopathy; plasma exchange; postpartum
• Online Access: http://www.ajts.org/article.asp?issn=0973-6247;year=2019;volume=13;issue=2;spage=90;epage=94;aulast=Hans

BACKGROUND: Postpartum microangiopathies are rare but are associated with high maternal and fetal mortality requiring early diagnosis and prompt treatment to improve the outcome. AIMS AND OBJECTIVES: This retrospective study aims to assess the efficacy of plasma exchange (PE) therapy in postpartum thrombotic microangiopathies. MATERIALS AND METHODS: We did retrospective analysis of all plasma exchange procedures performed in patients of postpartum thrombotic microangiopathies over a period of 1 year (2015-2016). Patient's pre- and post-plasma exchange hematological and biochemical parameters were recorded and compared for analyzing the response to the therapy. Patients were followed telephonically even after their discharge from the hospital. RESULTS: Hematological and renal profile improved in 8 out of 9 patients after PE therapy. Survival after PE therapy was 40% in post partum atypical HUS and 75% in patients with HELLP syndrome at 4 months of follow up. CONCLUSION: Early initiation of PE therapy in postpartum thrombotic microangiopathies can reduce morbidity and mortality associated with them.