University of Worcester Worcester Research and Publications
 
  USER PANEL:
  ABOUT THE COLLECTION:
  CONTACT DETAILS:

Thrombotic Thrombocytopenic Purpura and Pregnancy: Presentation, Management, and Subsequent Pregnancy Outcomes

Scully, M., Thomas, M., Underwood, M., Watson, H., Langley, K., Camilleri, Raymond S., Clark, A., Creagh, D., Rayment, R., Mcdonald, V., Roy, A., Evans, G., McGuckin, S., Ni Ainle, F., Maclean, R., Lester, W., Nash, M., Scott, R. and O Brien, P. (2014) Thrombotic Thrombocytopenic Purpura and Pregnancy: Presentation, Management, and Subsequent Pregnancy Outcomes. Blood, 124 (2). pp. 211-219. ISSN Print: 0006-4971 Online: 1528-0020

Full text not available from this repository. (Request a copy)

Abstract

In women presenting with an initial diagnosis of TTP during pregnancy, cTTP was more common than acquired TTP.Active monitoring and management during pregnancy results in positive pregnancy outcomes.Pregnancy can precipitate thrombotic thrombocytopenic purpura (TTP). We present a prospective study of TTP cases from the United Kingdom Thrombotic Thrombocytopenic Purpura (UK TTP) Registry with clinical and laboratory data from the largest cohort of pregnancy-associated TTP and describe management through pregnancy, averting fetal loss and maternal complications. Thirty-five women presented with a first TTP episode during pregnancy: 23/47 with their first congenital TTP (cTTP) episode and 12/47 with acute acquired TTP in pregnancy. TTP presented primarily in the third trimester/postpartum, but fetal loss was highest in the second trimester. Fetal loss occurred in 16/38 pregnancies before cTTP was diagnosed, but in none of the 15 subsequent managed pregnancies. Seventeen of 23 congenital cases had a missense mutation, C3178T, within exon 24 (R1060W). There were 8 novel mutations. In acquired TTP presentations, fetal loss occurred in 5/18 pregnancies and 2 terminations because of disease. We also present data on 12 women with a history of nonpregnancy-associated TTP: 18 subsequent pregnancies have been successfully managed, guided by ADAMTS13 levels. cTTP presents more frequently than acquired TTP during pregnancy and must be differentiated by ADAMTS13 analysis. Careful diagnosis, monitoring, and treatment in congenital and acquired TTP have assisted in excellent pregnancy outcomes.

Item Type: Article
Additional Information:

The full-text of the published article can be accessed via the official URL.

Uncontrolled Discrete Keywords: pregnancy, Thrombotic Thrombocytopenic Purpura
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: College of Health, Life and Environmental Sciences > School of Science and the Environment
Related URLs:
Depositing User: Raymond Camilleri
Date Deposited: 19 May 2019 20:29
Last Modified: 17 Jun 2020 17:29
URI: https://eprints.worc.ac.uk/id/eprint/8010

Actions (login required)

View Item View Item
 
     
Worcester Research and Publications is powered by EPrints 3 which is developed by the School of Electronics and Computer Science at the University of Southampton. More information and software credits.