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

Abstract

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.