Biomaterial Database

How we manage thrombotic microangiopathies in pregnancy. 2016

Mari R Thomas, and Susan Robinson, and Marie A Scully

Department of Haematology, UCLH, Cardiometabolic programme- NIHR UCLH/UCL BRC, London, UK.

Differentiation between the thrombotic microangiopathies (TMAs) that present in pregnancy may be clinically challenging, but is critical to ensure correct management because of the impact on fetal and maternal outcomes. Thrombotic thrombocytopenic purpura (TTP) and atypical haemolytic uraemic syndrome (aHUS) are medical/obstetric emergencies that require specialist input, both at the time of acute diagnosis and follow-up in subsequent pregnancies. Features of preeclampsia and HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) may precede or be present in evolving TTP or aHUS. Clinicians need to be mindful of how a presumed diagnosis of a specific TMA in pregnancy may evolve and be prepared to frequently reassess signs and symptoms and revise the diagnosis and management plan accordingly.

UI	MeSH Term	Description	Entries
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011250	Pregnancy Complications, Hematologic	The co-occurrence of pregnancy and a blood disease (HEMATOLOGIC DISEASES) which involves BLOOD CELLS or COAGULATION FACTORS. The hematologic disease may precede or follow FERTILIZATION and it may or may not have a deleterious effect on the pregnant woman or FETUS.	Complications, Hematologic Pregnancy,Hematologic Pregnancy Complications,Pregnancy Complications, Hematological,Pregnancy, Hematologic Complications,Complication, Hematologic Pregnancy,Complication, Hematological Pregnancy,Complications, Hematological Pregnancy,Hematologic Pregnancy Complication,Hematological Pregnancy Complication,Hematological Pregnancy Complications,Pregnancies, Hematologic Complications,Pregnancy Complication, Hematologic,Pregnancy Complication, Hematological
D003937	Diagnosis, Differential	Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures.	Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D057049	Thrombotic Microangiopathies	Diseases that result in THROMBOSIS in MICROVASCULATURE. The two most prominent diseases are PURPURA, THROMBOTIC THROMBOCYTOPENIC; and HEMOLYTIC-UREMIC SYNDROME. Multiple etiological factors include VASCULAR ENDOTHELIAL CELL damage due to SHIGA TOXIN; FACTOR H deficiency; and aberrant VON WILLEBRAND FACTOR formation.	Microangiopathies, Thrombotic,Microangiopathy, Thrombotic,Thrombotic Microangiopathy
D019468	Disease Management	A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596)	Disease Managements,Management, Disease,Managements, Disease
D065766	Atypical Hemolytic Uremic Syndrome	An hereditary hemolytic uremic syndrome associated with variations in the gene that encodes COMPLEMENT FACTOR H, or the related proteins CFHR1 and CFHR3. Disease often progresses to CHRONIC KIDNEY FAILURE without the prodromal symptoms of ENTEROCOLITIS and DIARRHEA that characterize typical hemolytic uremic syndrome.	Atypical Hemolytic-Uremic Syndrome,Hemolytic Uremic Syndrome, Atypical,Non-Shiga-Like Toxin-Associated HUS,Non-Stx-Hus,Nonenteropathic HUS,Atypical Hemolytic-Uremic Syndromes,HUS, Non-Shiga-Like Toxin-Associated,HUS, Nonenteropathic,HUSs, Non-Shiga-Like Toxin-Associated,HUSs, Nonenteropathic,Hemolytic-Uremic Syndrome, Atypical,Hemolytic-Uremic Syndromes, Atypical,Non Shiga Like Toxin Associated HUS,Non Stx Hus,Non-Shiga-Like Toxin-Associated HUSs,Nonenteropathic HUSs,Syndrome, Atypical Hemolytic-Uremic,Syndromes, Atypical Hemolytic-Uremic,Toxin-Associated HUS, Non-Shiga-Like,Toxin-Associated HUSs, Non-Shiga-Like