scholarly journals How to evaluate and treat the spectrum of TMA syndromes in pregnancy

Hematology ◽  
2021 ◽  
Vol 2021 (1) ◽  
pp. 545-551
Author(s):  
Marie Scully
Keyword(s):  
Multidisciplinary Approach ◽  
Liver Enzymes ◽  
Organ Damage ◽  
Pregnancy Induced Hypertension ◽  
Fetal Outcomes ◽  
Treatment Pathway ◽  
Elevated Liver Enzymes ◽  
Induced Hypertension ◽  
Uremic Syndrome ◽  
In Pregnancy

Abstract Thrombotic microangiopathy (TMA) is the broad definition for thrombocytopenia, microangiopathic hemolytic anemia, and end-organ damage. Two important categories are thrombotic thrombocytopenic purpura (TTP) and complement-mediated hemolytic-uremic syndrome (CM-HUS). Pregnancy and the immediate postpartum period are associated with TMAs specific to pregnancy in rare situations. These include pregnancy-induced hypertension, preeclampsia, and hemolysis, elevated liver enzymes, and low platelets. TTP and CM-HUS may present in pregnancy. However, the diagnosis may not be immediately obvious as they share characteristics of pregnancy-related TMAs. Within this review, we discuss investigations, differential diagnosis of TMAs in pregnancy, and management. The importance is a risk of maternal mortality but also poor fetal outcomes in relation to TTP and CM-HUS. Treatment of these disorders at presentation in pregnancy is discussed to achieve remission and prolong fetal viability if possible. In subsequent pregnancies, a treatment pathway is presented that has been associated with successful maternal and fetal outcomes. Critical to this is a multidisciplinary approach involving obstetricians, the fetal medicine unit, and neonatologists.

scholarly journals Babesiosis in Pregnancy: An Imitator of HELLP Syndrome

2019 ◽  
Vol 09 (02) ◽  
pp. e147-e152 ◽  
Author(s):  
Raminder Khangura ◽  
Nayo Williams ◽  
Shontreal Cooper ◽  
Anne- Marie Prabulos
Keyword(s):  
Hellp Syndrome ◽  
Clinical Presentation ◽  
Liver Enzymes ◽  
Neonatal Morbidity ◽  
Pregnancy Complication ◽  
Morbidity And Mortality ◽  
Fetal Outcomes ◽  
Laboratory Findings ◽  
Elevated Liver Enzymes ◽  
In Pregnancy

AbstractHELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) is a serious pregnancy complication that can cause significant maternal and neonatal morbidity and mortality. There are several conditions that may occur in pregnancy that may imitate the laboratory findings and clinical presentation of HELLP syndrome. Babesiosis is a parasitic imitator of HELLP syndrome that can be spread by the tick, transfusions, or congenitally. Recognition and treatment of this condition is important to optimize maternal and fetal outcomes.

scholarly journals Triad of Idiopathic Thrombocytopenic Purpura, Preeclampsia, and HELLP Syndrome in a Parturient: A Rare Confrontation to the Anesthetist

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Tanu Mehta ◽  
Geeta P. Parikh ◽  
Veena R. Shah
Keyword(s):  
Caesarean Section ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Liver Enzymes ◽  
Rare Complication ◽  
Anesthetic Management ◽  
Emergency Caesarean Section ◽  
Pregnancy Induced Hypertension ◽  
Thrombocytopenic Purpura ◽  
Elevated Liver Enzymes ◽  
Induced Hypertension

Idiopathic thrombocytopenic purpura (ITP) with HELLP represents a rare complication that requires combined care of obstetrician, anesthesiologist, hematologist, and neonatologist. At 37-week gestation a 35-year-old parturient (G2A1P0) a known case of chronic ITP presented with severe pregnancy induced hypertension (PIH), thrombocytopenia, and elevated liver enzymes. We describe successful anesthetic management of this patient who was taken for emergency caesarean section.

scholarly journals Serum Lactate Dehydrogenase Level in Pregnancy Induced Hypertension and Fetomaternal Outcome

2021 ◽  
Vol 23 (4) ◽  
pp. 275-280
Author(s):  
Sarmila Prajapati ◽  
Bekha Laxmi Manandhar ◽  
Suvana Maskey ◽  
Jyoti Sharma
Keyword(s):  
Lactate Dehydrogenase ◽  
University Teaching ◽  
Serum Lactate Dehydrogenase ◽  
Hypertensive Disorder ◽  
Pregnancy Induced Hypertension ◽  
Maternal Complications ◽  
Elevated Liver Enzymes ◽  
Induced Hypertension ◽  
Fetal Complications ◽  
In Pregnancy

Hypertensive disorders complicate 5-10% of all pregnancies and associated with potentially dangerous maternal and fetal complications. Studies have shown that pre-eclamptic patients with higher levels of lactate dehydrogenase (LDH) are at high risk of developing subsequent complications with poor maternal and fetal outcome. So with the aim to correlate serum LDH level in pregnancy induced hypertension (PIH) with fetomaternal outcome this hospital based observational descriptive study was done at Tribhuvan University Teaching Hospital (TUTH) for the duration of 1 year from 15th May, 2018 to 14th May, 2019. Women with PIH fulfilling inclusion criteria were enrolled in the study. Serum LDH level was measured and severity of PIH, maternal and perinatal outcome were studied according to the levels of LDH. Results were analyzed using SPSS 18. The incidence of hypertensive disorder in pregnancy was 4.74% in this study and total 180 cases were enrolled. The mean serum LDH level increased with increase in severity of PIH. Thirty two (17.7%) cases had maternal complications and hemolysis elevated liver enzymes and low platelet (HELLP) syndrome was most common complication. More than 2/3rd (62.5%) of cases with LDH level >800 IU/L had complications. The most common perinatal complication was intrauterine growth restriction (IUGR). The perinatal morbidity and mortality were significantly high in patients with PIH with LDH level >800 IU/l. As with the increase in serum LDH level increase in maternal and fetal complications was observed, LDH can be a useful biochemical marker that reflects the severity of PIH.

Role of dyslipidaemia and lipid peroxidation in pregnancy induced hypertension

2015 ◽  
Vol 4 (3) ◽  
pp. 205 ◽  
Author(s):  
Shikha Saxena ◽  
KV Thimmaraju ◽  
PremC Srivastava ◽  
AyazK Mallick ◽  
Biswajit Das ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
In Pregnancy
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