Management of thrombotic microangiopathy in pregnancy and postpartum: report from an international working group.

Details

Serval ID
serval:BIB_307584AB9C47
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Management of thrombotic microangiopathy in pregnancy and postpartum: report from an international working group.
Journal
Blood
Author(s)
Fakhouri F., Scully M., Provôt F., Blasco M., Coppo P., Noris M., Paizis K., Kavanagh D., Pene F., Quezada S., Hertig A., Kissling S., O'Brien P., Delmas Y., Alberio L., Winer N., Veyradier A., Cataland S.R., Fremeaux-Bacchi V., Loirat C., Remuzzi G., Tsatsaris V.
ISSN
1528-0020 (Electronic)
ISSN-L
0006-4971
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Pregnancy and postpartum are high-risk periods for different forms of thrombotic microangiopathy (TMA). However, the management of pregnancy-associated TMA remains ill-defined. This report by an international multidisciplinary (obstetricians, nephrologists, hematologists, intensivists, neonatologists and complement biologists) working group summarizes the current knowledge of these potentially severe disorders and proposes a practical clinical approach to diagnose and manage an episode of pregnancy-associated TMA. This approach takes into account the timing of TMA in pregnancy or postpartum, co-existing symptoms, first-line laboratory work-up and probability-based assessment of possible causes of pregnancy-associated TMA. Its aims are to urgently rule in or out thrombotic thrombocytopenic purpura (TTP) with ADAMTS13 activity testing, to consider alternative disorders with features of TMA (preeclampsia/eclampsia, Hemolysis Elevated Liver enzymes Low Platelets (HELLP) syndrome, antiphospholipid syndrome (APS)) or ultimately to diagnose complement-mediated atypical hemolytic uremic syndrome (aHUS) as a diagnosis of exclusion. Even though rare, it is paramount to diagnose TTP and aHUS associated with pregnancy and postpartum, as both require urgent specific treatment.
Pubmed
Create date
28/08/2020 8:18
Last modification date
03/09/2020 6:26
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