Abstract:

Objective: To improve the understanding and diagnostic and treatment level of pregnancy-associated hemolytic uremic syndrome (HUS). Methods: The clinical data of 14 patients with pregnancy-associated HUS who were hospitalized and delivered in the Tianjin Medical University General Hospital from May 2008 to February 2024 were retrospectively analyzed, including the clinical characteristics, treatment methods and prognosis. Results: Preeclampsia was complicated in all of 14 patients, in which 11 cases occurred in the postpartum period. All of 14 patients presented with oliguria or anuria with hemolytic anemia, thrombocytopenia, and acute kidney injury. Plasma exchange and continuous renal replacement therapy (CRRT) were the main treatment methods, combined with low molecular heparin, glucocorticoids and other comprehensive treatment. All of patients were discharged after effective comprehensive treatment, confirming that the plasma exchange combined with CRRT has a better long-term prognosis. Within a follow-up visit of 0.5 to 14 years, 1 case received renal transplantation, 7 cases suffered from chronic kidney disease (CKD), 6 cases were cured, and there were no fatal cases. Conclusions: Pregnancy-associated HUS as a disease of rare onset and very poor prognosis should be diagnosed as early as possible, and the timely administration of blood purification and comprehensive treatment will help to improve the conditions of disease.

Key words: Atypical hemolytic uremic syndrome, Pregnancy complications, Pre-eclampsia, Continuous renal replacement therapy, Plasma exchange