Clinical and laboratory features of pregnancy-specific TMAs, nonpregnancy specific TMAs, and DIC
| . | Preeclampsia with severe features/HELLP . | AFLP . | TTP . | cm-TMA . | DIC . |
|---|---|---|---|---|---|
| Estimated incidence/pregnancies* | 1/20 preeclampsia 1/1000 HELLP | 1/7000-1/20 000 | 1/200 000 | 1/25 000 | 3/1000 |
| Elevated blood pressure | +++ | ++ (50% of cases) | + | + | - |
| Neurologic abnormalities | +/++ (headache) | + | +++ (change in mental status, headaches, weakness) | + | – |
| Platelet count, × 109/L | 50-100 | 50-100 | <30 | <100 | <100 |
| Red blood cell fragmentation | + | + | +/+++ | +/++ | + |
| Renal impairment | –/+ | ++/+++ | –/+ | +++ | – |
| AST/ALT elevation | –/+ | +++ | – | – | – |
| Elevated PT coagulopathy | – | +++ | – | – | +/– |
| ADAMTS13 | >20% | >20% | <10% | >20% | >20% |
| Other comments | – | Elevated ammonia, low blood glucose | – | – | Biochemical evidence of DIC more common than overt DIC in pregnancy |
| . | Preeclampsia with severe features/HELLP . | AFLP . | TTP . | cm-TMA . | DIC . |
|---|---|---|---|---|---|
| Estimated incidence/pregnancies* | 1/20 preeclampsia 1/1000 HELLP | 1/7000-1/20 000 | 1/200 000 | 1/25 000 | 3/1000 |
| Elevated blood pressure | +++ | ++ (50% of cases) | + | + | - |
| Neurologic abnormalities | +/++ (headache) | + | +++ (change in mental status, headaches, weakness) | + | – |
| Platelet count, × 109/L | 50-100 | 50-100 | <30 | <100 | <100 |
| Red blood cell fragmentation | + | + | +/+++ | +/++ | + |
| Renal impairment | –/+ | ++/+++ | –/+ | +++ | – |
| AST/ALT elevation | –/+ | +++ | – | – | – |
| Elevated PT coagulopathy | – | +++ | – | – | +/– |
| ADAMTS13 | >20% | >20% | <10% | >20% | >20% |
| Other comments | – | Elevated ammonia, low blood glucose | – | – | Biochemical evidence of DIC more common than overt DIC in pregnancy |
Table adapted from Cines and Levine.3 Thrombocytopenia in pregnancy. Blood. 2017;130(21) with permission from Elsevier.
Estimated incidence as reported in Scully.10
+, relative prevalence; −, not usually present; AFLP, acute fatty liver of pregnancy; ALT, alanine aminotransferase; AST, aspartate aminotransferase; DIC, disseminated intravascular coagulation; PT, prothrombin time.