• A&A practice · May 2021

    Case Reports

    Atypical Hemolytic-Uremic Syndrome Following Obstetric Hemorrhage in the Setting of Fetal Demise and Placenta Accreta: A Case Report.

    • Ryan Wang, Chloe Getrajdman, Daniel Blech, Sarp Aksel, Samuel Bender, and Daniel Katz.
    • From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
    • A A Pract. 2021 May 14; 15 (5): e01476.

    AbstractMultiple disease processes can contribute to coagulopathy in the setting of intrauterine fetal demise. A 34-year-old woman with multiple prior uterine surgeries presented for dilation and evacuation of a fetal demise at 17 weeks. Her case was complicated by significant hemorrhage and coagulopathy requiring massive transfusion and hysterectomy. She developed atypical hemolytic-uremic syndrome postoperatively. Pathology identified a focal placenta accreta. While not known to present together, fetal demise, placenta accreta, and atypical hemolytic-uremic syndrome can occur in the same patient with an overlapping presentation. Early hematology consultation is recommended in the setting of ongoing hemolysis and renal dysfunction.Copyright © 2021 International Anesthesia Research Society.

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