| Thrombotic thrombocytopenic purpura in 166 pregnancies: 1955-2006. | |
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MedLine Citation:
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PMID: 18456236 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A review of pregnancy-associated thrombotic thrombocytopenic purpura (TTP) in 166 pregnancies was undertaken using 92 English-language publications from 1955 to 2006. Initial and recurrent TTP presents most often in the second trimester (55.5%) after 1-2 days of signs/symptoms; postpartum TTP usually occurs following term delivery. TTP with preeclampsia (n = 28) exhibits 2-4 times higher aspartate aminotransferase (AST) values and lower total lactate dehydrogenase (LDH) to AST ratios (LDH to AST ratio = 13:1), compared with TTP without preeclampsia (LDH to AST ratio = 29:1). Maternal mortality is higher with initial TTP (26% vs 10.7%), especially with concurrent preeclampsia (44.4% vs 21.8%, P < .02). Although maternal mortality with TTP has substantially declined when plasma therapy is utilized, delay of diagnosis and therapy for initial TTP confounded by preeclampsia/hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome remains a significant maternal-perinatal threat. Rapid and readily available laboratory testing to quickly diagnose TTP and HELLP syndrome/preeclampsia is desperately needed to improve care. |
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Authors:
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James N Martin; Amelia P Bailey; Jonathan F Rehberg; Michelle T Owens; Sharon Dixon Keiser; Warren L May |
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Publication Detail:
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Type: Journal Article; Review Date: 2008-05-23 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 199 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-08-04 Completed Date: 2008-08-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 98-104 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Divisions of Maternal-Fetal Medicine and Women's Health, University of Mississippi Medical Center, Jackson, MS, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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ADAM Proteins
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blood Aspartate Aminotransferases / blood Female HELLP Syndrome / diagnosis, therapy Humans L-Lactate Dehydrogenase / blood Maternal Mortality Pregnancy Pregnancy Complications, Cardiovascular / diagnosis*, mortality, therapy* Purpura, Thrombotic Thrombocytopenic / diagnosis*, mortality, therapy* |
| Chemical | |
Reg. No./Substance:
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EC 1.1.1.27/L-Lactate Dehydrogenase; EC 2.6.1.1/Aspartate Aminotransferases; EC 3.4.24.-/ADAM Proteins; EC 3.4.24.-/ADAMTS13 protein, human |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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