Aim: The purpose of this study was to review all obstetric patients admitted to ICU in Ain Shams University Maternity Hospital over 5-years period due to thrombotic microangiopathies (SPET, HELLP, HUS, AFLP, TTP), thereby to analyze the frequency, clinical characteristics, interventions, treatment, and maternal and neonatal outcomes
Patients and methods: We reviewed medical charts of above-mentioned patients.
Results: The patients’ age was 30.22 ± 6.24 years, with parity of 3.3±1.16. Most were admitted at postpartum period, and ICU stay was 2.8 ± 1.64 days. Hypertension (24%) and DM (16%) were the most common co-morbidities. The neonatal weight was 2.35 ± 0.82, and the incidence of IUGR was 2.7%. Neonatal weight from AFLP was significantly low. Maternal death occurred in 28 (4.7%) due to HELLP (n=8), HUS (4), undiagnosed (4), AFLP (4), SPET (4), eclampsia (4). Death was due to multi-organ failure, pulmonary emboli, DIC, cerebral hemorrhage and stroke. Regarding the complications, 12 (2%) suffered with eclampsia, 28 (4.7%) with accidental hemorrhage, and 8 (1.3%) with renal failure. The incidence of antepartum Hemorrhage was higher among patients with HUS-TTP than those with PE-Eclampsia-HELLP by 33% for HUS-TTP versus 3.5% for PE-Eclampsia-HELLP. Thus, pregnant patients with TTP-HUS had a greater risk of maternal complications than those with PE-Eclampsia-HELLP.
Conclusion: Some demographic, clinical, and laboratory characteristics could correlate with specific types of MAHA. Physicians should be aware of this.