Spectrum of Acute Kidney Injury in Pregnancy associated Thrombotic Microangiopathy

Abstract

Thrombotic microangiopathy (TMA) is characterized by microvascular thrombosis due to endothelial injury or abnormal platelet aggregation. It commonly manifests as microangiopathic hemolytic anaemia, thrombocytopenia and organ injury that may include acute kidney injury (AKI). It has a diverse etiology. Pregnancy associated TMA represents a secondary form that may be caused by complement mediated Hemolytic Uremic Syndrome (HUS), Thrombotic Thrombocytopenic Purpura (TTP) and preeclampsia-eclampsia, Rarely, renal cortical necrosis – a catastrophic event, may be seen in pregnancy-related TMA. We discuss three cases of thrombotic microangiopathy related to pregnancy. TMA is associated with significant fetomaternal morbidity and mortality and hence a rapid diagnosis and prompt disease management is crucial for a favourable patient outcome.