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  3. Pregnancy outcomes following recovery from acquired thrombotic thrombocytopenic purpura.

Pregnancy outcomes following recovery from acquired thrombotic thrombocytopenic purpura.

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DOI
10.7892/boris.48673
Publisher DOI
10.1182/blood-2013-11-538900
PubMed ID
24398329
Abstract
Pregnancy may precipitate acute episodes of thrombotic thrombocytopenic purpura (TTP), but pregnancy outcomes in women who have recovered from acquired TTP are not well documented. We analyzed pregnancy outcomes following recovery from TTP associated with acquired, severe ADAMTS13 deficiency (ADAMTS13 activity <10%) in women enrolled in the Oklahoma TTP-HUS Registry from 1995 to 2012. We also systematically searched for published reports on outcomes of pregnancies following recovery from TTP associated with acquired, severe ADAMTS13 deficiency. Ten women in the Oklahoma Registry had 16 subsequent pregnancies from 1999 to 2013. Two women had recurrent TTP, which occurred 9 and 29 days postpartum. Five of 16 pregnancies (31%, 95% confidence interval, 11%-59%) in 3 women were complicated by preeclampsia, a frequency greater than US population estimates (2.1%-3.2%). Thirteen (81%) pregnancies resulted in normal children. The literature search identified 382 articles. Only 6 articles reported pregnancies in women who had recovered from TTP associated with acquired, severe ADAMTS13 deficiency, describing 10 pregnancies in 8 women. TTP recurred in 6 pregnancies. Conclusions: With prospective complete follow-up, recurrent TTP complicating subsequent pregnancies in Oklahoma patients is uncommon, but the occurrence of preeclampsia may be increased. Most pregnancies following recovery from TTP in Oklahoma patients result in normal children.
Date Issued
2014-03-13
Publication Type
Article
Subject(s)
600 Technology > 610 Medicine & health
Language(s)
en
Author(s)
Jiang, Yang
McIntosh, Jennifer J
Reese, Jessica A
Deford, Cassandra C
Kremer Hovinga Strebel, Johanna Anna  
Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor  
Lämmle, Bernhard  
Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor  
Terrell, Deirdra R
Vesely, Sara K
Knudtson, Eric J
George, James N
Additional Credits
Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor  
Journal
Blood
Publisher
American Society of Hematology
ISSN
0006-4971
Access(Rights)
restricted
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