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Preventing maternal deaths due to acquired thrombotic thrombocytopenic purpura.
MedLine Citation:
PMID:  22690700     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In order to identify the cause of maternal deaths due to thrombotic thrombocytopenic purpura (TTP) and identify future preventative measures we retrospectively reviewed all maternal deaths due to TTP in London from 2003 to 2008 that were confirmed on post-mortem examination. There were three maternal deaths due to sudden cardiac arrest within 1, 5 and 2 days of presentation, respectively. Post-mortem findings revealed they all died with intramyocardial microvascular thrombosis, the thrombi being characteristically platelet rich (CD61+, fibrin-). Platelet thrombi in the coronary microvasculature are the cause of early sudden death in TTP in pregnancy. If TTP cannot be excluded in the differential diagnosis of thrombotic microangiopathies of pregnancy, then plasmapheresis should be instituted as a medical emergency. ADAMTS-13 levels are helpful in making the diagnosis, but results should not be awaited before instituting plasmapheresis.
Authors:
Beverley J Hunt; Rowena R Thomas-Dewing; Kate Bramham; Sebastian B Lucas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-13
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  -     ISSN:  1447-0756     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.
Affiliation:
Departments of Thrombosis and Haemostasis Histopathology, Guy's & St Thomas' Hospital NHS Foundation Trust Maternal and Fetal Research Unit, King's College London, London, UK.
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