Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 10 , ISSUE 2 ( April-June, 2018 ) > List of Articles

CASE REPORT

Life-threatening Thrombotic Complications in Pregnancy

Sunita Kumar

Keywords : Hemolytic uremic syndrome, Life-threatening thrombotic complications, Pregnancy Thrombotic complications in pregnancy, Thrombotic thrombocytopenic purpura

Citation Information : Kumar S. Life-threatening Thrombotic Complications in Pregnancy. J South Asian Feder Obs Gynae 2018; 10 (2):138-141.

DOI: 10.5005/jp-journals-10006-1577

Published Online: 01-06-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Aim: Thrombotic complications like thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), and posterior reversible encephalopathy syndrome (PRES) in pregnancy are due to the deposits of platelet and fibrin in the microvasculature damaging and destroying the passing red blood cells (RBCs) and platelets so as to cause hemolysis, thrombocytopenia, and anemia. They are relatively rare fulminant life-threatening conditions, which can lead to significant perinatal and maternal morbidity and/or mortality. Pregnancy itself is thrombus prone and conditions like preeclamptic toxemia (PET), eclampsia, and hemolysis, elevated liver enzymes, and low platelet count (HELLP) are not only occasionally associated, but can add to the gravity of the seriousness. Case report: Three cases each of TTP, HUS, and PRES are being presented with their case history treatment and outcome to show the similarity in their presentation along with diagnostic dilemma, clinching diagnostic tests, and overall management with specific treatment in individual cases. Conclusion: The TTP, HUS, and PRES are life-threatening complications in pregnancy without any signs of early recognition. Awareness of the condition and prompt action is the need to avoid perinatal and maternal mortality and morbidity associated with these syndromes.


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  1. Kuter, DJ. Thrombotic Thrombocytopenic Purpura (TTP) and Haemolytic Uremic Syndrome (HUS). Kenilworth (NJ): Merck & Co. Inc.; 2017.
  2. Fakhouri F, Roumenina L, Provot F, Sallée M, Caillard S, Couzi L, Essig M, Ribes D, Dragon-Durey MA, Bridoux F, et al. Pregnancy-associated haemolytic uremic syndrome revisited in the era of complement gene mutations. J Am Soc Nephrol 2010 May;21(5):859-867.
  3. George JN. The association of pregnancy with thrombotic thrombocytopenic purpura-haemolytic uremic syndrome. Curr Opin Hematol 2003 Sep;10(5):339-344.
  4. Parmar, MS. Hemolytic-uremic syndrome. Medscape. 2015. [cited 2016 Sep 19]. Available from: http://emedicine.medscape. com/article/201181-overview.
  5. Christakos, P.; Lopez, I.; Triulzi, D. Final diagnosis—haemolytic uremic syndrome of pregnancy. Pittsburgh (PA): UPMC.
  6. Elliott MA, Nichols WL. Thrombotic thrombocytopenic purpura and haemolytic uremic syndrome. Mayo Clin Proc 2001 Nov;76(11):1154-1162.
  7. Wessel CH, Andreescu CE, Rombout-De Weerd S, Levin MD. Postpartum microangiopathic disorders: a case report and review of literature. Case Rep Womens Health 2014 Jul-Dec; 3-4:3-6.
  8. Fyfe-Brown A, Clarke G, Nerenberg K, Chandra S, Jain V. Management of pregnancy associated thrombotic thrombocytopenic purpura. AJP Rep 2013 May;3(1):45-50.
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