THE ROLE AND PLACE OF PLASMA EXCHANGE IN THE THERAPY OF THROMBOTIC MICROANGIOPATHY SYNDROME IN OBSTETRICS


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Abstract

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.

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About the authors

Tatiana A. Fedorova

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia

Email: tfedorova1@mail.ru
Ph.D., MD., Prof., Chief of transfusion department 117997, Russia, Moscow, Ac. Oparina str. 4

Elena V. Strelnikova

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia

Email: е_strelnikova@oparina4.ru
MD, doctor of transfusion department 117997, Russia, Moscow, Ac. Oparina str. 4

Oleg V. Rogachevskiy

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia

Email: o_rogachevskiy@oparina4.ru
PhD, MD, head of the Department of extracorporal methods of treatment and detoxification 117997, Russia, Moscow, Ac. Oparina str. 4

Alexey V. Pyregov

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia

Email: a_pyregov@oparina4.ru
PhD, MD, head of the department of anesthesiology and intensive care 117997, Russia, Moscow, Ac. Oparina str. 4

Tatyana K. Puchko

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia

Email: t_puchko@oparina4.ru
PhD, MD, Leading scientific employee of the physiological obstetrics department 117997, Russia, Moscow, Ac. Oparina str. 4

Maria A. Vinogradova

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia

Email: mary-grape@ya.ru
MD, Head Department of Reproductive Hematology and Clinical Hemostasiology 117997, Russia, Moscow, Ac. Oparina str. 4

Tatyana V. Kirsanova

National Medical Research Center of Obstetrics, Gynecology, and Perinatology Academician named after V.I. Kulakov, Ministry of Health of Russia

Email: A_Tatya@mail.ru
MD, senior research fellow of the Department of Reproductive Hematology and Clinical Hemostasiology 117997, Russia, Moscow, Ac. Oparina str. 4

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