Experiences and Lessons of One Postpartum Thrombotic Thrombocytopenic Purpura with Hemorrhage Lead to Preg-nancy-related Acute Kidney Injury
YANG Xin-jun
LIN Jing
WANG Jing-hua
LIU Yu
CHEN Yun-shuang
WU Guang-li
Abstract：Objective To investigate pathogenesis and the treatment measure of patients with acute kidney injury ( AKI) after cesarean in order to improve rescuing ability of pregnancy-related acute kidney injury ( PR-AKI) . Methods Clinical data of one patient with PR-AKI at postoperative 5th d after cesarean section was retrospectively analyzed. Results A 31-year old woman was admitted for edema and oliguresis at postoperative 5th d after cesarean section, and she was diagnosed as having AKI caused by thrombotic thrombocytopenic purpura ( TTP) , combined with infection, anemia, thrombocytopenia, liver and renal function damage, high phosphocreatinase, thrombin dysfunction. Physical examination discovered the hemato-ma in the right femoral vein and abdominal hematoma was confirmed by ultrasonic testing. She accepted embolotherapy when arteriography verified the bleeding of two branchs in the right internal iliac artery. In course of disease, she had nasal bleeding and haemorrhoids bleeding. She had accepted anti-infection, hemofiltration and glucocorticoid therapy, recoveried and dis-charged two and a half months later. Conclusion Both the TTP and postpartum hemorrhage are importance pathogenesis of PR-AKI, the patient′s condition worsened when they coexistd. If inoperable, angiograph testing can clear and definite the bleeding reason and position, reduce the misdiagnosis, electivity transarterial embolization can prevent the illness and recovery renal function.
Keywords：CesareanComplicationPostpartum hemorrhageAcute kidney injuryPurpurathrombotic thrombocy-topenic purpura
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 34-37 )