The role and place of plasma exchange in the therapy of thrombotic microangiopathy syndrome in obstetrics
The data available in the current literature on the role and place of therapeutic plasma exchange in the treatment of thrombotic microangiopathy (TMA) syndrome characterized by thrombocytopenia, hemolytic anemia, microvascular thrombosis in various organs, and by elevated hepatic enzyme levels and multiple organ dysfunction. Data analysis has shown that therapeutic plasma exchange that has a multicomponent effect is pathogenetically justified and essential in the treatment of patients with pregnancy-associated TMA, which makes it possible to considerably reduce the clinical manifestations of the disease, to rapidly decrease the biochemical markers of hepatic and renal failure, to stabilize the blood coagulation and fibrinolytic potential, to prevent the severe forms of TMA, and to save the life of a female patient. Further multicenter studies of the complex pathophysiology of HELLP syndrome and other TMAs associated with pregnancy are required to prove the efficiency of extracorporeal hemocorrection methods.Fedorova T.A., Strelnikova E.V., Rogachevsky O.V., Pyregov A.V., Puchko T.K., Vinogradova M.A., Kirsanova T.V.
Keywords
thrombotic microangiopathy
preeclampsia
HELLP syndrome
atypical hemolytic uremic syndrome
thrombotic thrombocytopenic purpura
therapeutic plasma exchange
efficacy
References
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Received 04.10.2017
Accepted 27.10.2017
About the Authors
Fedorova, Tatiana A., Ph.D., MD., Prof., Chief of transfusion department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Теl.: +74954387135. E-mail: t_fyodorova@oparina4.ruStrelnikova, Elena V., MD, doctor of transfusion department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named
after V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Теl.: +74954387135. E-mail: е_strelnikova@oparina4.ru
Rogachevskiy, Oleg V., PhD, MD, head of the Department of extracorporal methods of treatment and detoxification, National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Теl.: +74954387135. E-mail: о_rogachevskiy@oparina4.ru
Рyregov, Alexey V., PhD, MD, head of the department of anesthesiology and intensive care, National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Теl.: +74954387777. E-mail: a_pyregov@oparina4.ru
Puchko, Tatyana K., PhD, MD, Leading scientific employee of the physiological obstetrics department, National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Теl.: +74954387043. E-mail: t_puchko@oparina4.ru
Vinogradova, Maria A., MD, Head Department of Reproductive Hematology and Clinical Hemostasiology, National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Теl.: +74954387135. E-mail: mary-grape@ya.ru
Kirsanova, Tatyana V., MD, senior research fellow of the Department of Reproductive Hematology and Clinical Hemostasiology, National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Теl.: +79262484560. E-mail: A_Tatya@mail.ru
For citations: Fedorova T.A., Strelnikova E.V., Rogachevsky O.V., Pyregov A.V., Puchko T.K., Vinogradova M.A., Kirsanova T.V. The role and place of plasma exchange in the therapy of thrombotic microangiopathy syndrome in obstetrics. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (8): 5-11. (in Russian)
https://dx.doi.org/10.18565/aig.2018.8.5-11
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