Rosen M, Brauer K I, Alperin J B, Hankins G D V, Saade G
Department of Obstetrics and Gynecology, The University of Texas Medical Branch, Galveston, Texas 77555-0587, USA.
J Matern Fetal Neonatal Med. 2003 Mar;13(3):208-10. doi: 10.1080/jmf.13.3.208.210.
Thrombotic microangiopathies may be initiated by a number of antecedent events. When presented with postpartum hemorrhage and unexplained thrombocytopenia, it is prudent to consider microangiopathic hemolytic anemia in the differential diagnosis. A 25-year-old woman, gravida 2, para 1, had an uncomplicated repeat Cesarean delivery at 38 weeks' gestation. She subsequently had an exploratory laparotomy for hemoperitoneum resulting from a left uterine artery laceration. On postoperative day 3, she developed thrombotic chrombocytopenic purpura-hemolytic uremic syndrome and was treated with plasma exchange therapy and dialysis. It is critical that clinicians consider this potentially fatal disease in the differential diagnosis when hemorrhagic shock is associated with unexplained thrombocytopenia, so that appropriate and early treatment may lead to a favorable outcome.
血栓性微血管病可能由多种先前事件引发。当出现产后出血和不明原因的血小板减少时，在鉴别诊断中谨慎考虑微血管病性溶血性贫血是明智的。一名25岁女性，孕2产1，在妊娠38周时进行了一次无并发症的剖宫产。随后因左子宫动脉撕裂导致腹腔积血而接受了剖腹探查术。术后第3天，她发生了血栓性血小板减少性紫癜 - 溶血尿毒综合征，并接受了血浆置换疗法和透析治疗。当出血性休克与不明原因的血小板减少相关时，临床医生在鉴别诊断中考虑这种潜在致命疾病至关重要，以便适当的早期治疗可能带来良好的结果。
