What is TTP in pregnancy?
What is TTP in pregnancy?
Thrombotic thrombocytopenic purpura (TTP) is a rare but serious complication in pregnancy that places the mother and fetus at high risk for morbidity and mortality. This case illustrates novel pregnancy complications associated with this rare medical condition.
Is Purpura common in pregnancy?
Gestational thrombocytopenia explains 70-80% of all cases of thrombocytopenia in pregnancy. Hypertensive disorders account for approximately 20% and immune thrombocytopenic purpura for about 3-4%. Other etiologies are considered rare in pregnancy.
How do you know if you have TTP?
Blood clots, a low platelet count, and damaged red blood cells cause the signs and symptoms of thrombotic thrombocytopenic purpura (TTP). The signs and symptoms include: Purplish bruises on the skin or mucous membranes (such as in the mouth). These bruises, called purpura, are caused by bleeding under the skin.
Can pregnancy cause petechiae?
Many women have no symptoms, but are found to have a low platelet count during their routine pregnancy check ups. Some women may have problems with bruising or small red marks on the skin (these are known as purpura or petechiae). Occasionally some women may experience bleeding such as nosebleeds.
Do low platelets affect baby?
The baby is unlikely to develop low platelets if your decreased count is caused by regular dips in pregnancy or hypertension. However, if your low count is due to an immune condition, the antibodies that destroy platelets may cross the placenta and cause the same issues for the fetus.
How is TTP treated in pregnancy?
Plasma-based therapy is the mainstay of treatment for TTP. Plasmapheresis was developed in the 1970s and represented a major advance in the treatment of TTP. This therapy is thought to replenish the depleted levels of ADAMTS-13, thus reducing the thrombotic microangiopathy.
Why would a pregnant woman have low platelets?
It’s normal for your platelet count to dip by a few thousand during pregnancy, due in part to hemodilution: the body makes more plasma during pregnancy, so the total number of platelets per volume of blood will be lower.
What are some causes of thrombocytopenia in pregnancy?
Gestational thrombocytopenia (defined as a mild thrombocytopenia, occurring during the 3 rd trimester with spontaneous resolution postpartum and no neonatal thrombocytopenia) is the most common cause of thrombocytopenia during pregnancy but a low platelet can also be associated with several diseases, either pregnancy …
How to treat thrombotic thrombocytopenic purpura in pregnancy?
Barbara Ferrari, Flora Peyvandi; How I treat thrombotic thrombocytopenic purpura in pregnancy. Blood 2020; 136 (19): 2125–2132. doi: https://doi.org/10.1182/blood
How to know if you have inherited thrombocytopenic purpura ( TTP )?
These factors may include: Both inherited and acquired thrombotic thrombocytopenic purpura (TTP) occur suddenly with no clear cause. You can’t prevent either type. If you’ve had TTP, watch for signs and symptoms of a relapse (flareup).
Can a pregnancy cause thrombotic microangiopathy ( TTP )?
Thrombotic thrombocytopenic purpura (TTP) is an acute, life-threatening thrombotic microangiopathy (TMA) caused by acquired or congenital severe deficiency of ADAMTS13. Pregnancy is a recognized risk factor for precipitating acute (first or recurrent) episodes of TTP.
Can a fetus be born with thrombocytopenia?
TTP does not cause fetal thrombocytopenia but may result in IUGR and loss of the fetus. Patients with TTP during pregnancy should be treated as other patients with plasma exchange, guided by ADAMTS13 levels and urgent delivery of the fetus when possible. Untreated TTP is associated with a 90% maternal mortality. 114,127 View chapter Purchase book