Thrombotic thrombocytopenic purpura (TTP), haemolytic uremic syndrome and pregnancy-related syndromes like preeclampsia and HELLP-syndrome are grouped together as a complex called thrombotic microangiopathic disorder. Microangiopathic disorders may result in very severe disease, which puts the pregnant woman at a high risk, as well as her unborn child. Therefore, when dealing with a microangiopathic disorder, it is necessary to make a quick and targeted diagnostic and administer treatment in order to prevent the risk to the pregnancy. In diagnosing microangiopathic disorders, it is especially difficult to differentiate between HELLP-syndrome and TTP in an emergency, thus, when examining a patient, it is necessary to consider all possible diagnoses as well as all helpful factors such as history, clinical examination, gestational age, graduation of thrombocytopenia, and special laboratory tests (haemolysis parameter, Coombs-Test, ADAMTS-13 and fragmentocytes). Plasma exchange is the most effective option for treatment of these disorders. In general, application of platelet concentrate should be avoided, because it could worsen the microangiopathic and subsequent neurological situation.
Posted on: Mon, 10 Jun 2013 23:18:41 +0000
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