Abstract

Detecion of trombocytopenia and hemolytic anemia during pregnancy and the postpartum period alarms the physician becaus these are recognized as the signs of severe potentially life threatening syndromes such as pregnancy associated thrombotic thrombocytopenic purpura (TTP), hemolysis-elevated liver enzymes-low platet count (HELLP) syndrome, and postpartum hemolytic uremic syndrome (PHUS). Subsequent to different initial insults the final pathologic processes produce similar clinacal pictures, and although their treatments differ considerably many times differential diagnosis of these three clinical syndromes is impossible before starting empiric treatment. Plasmapheresis with plasma exchange is the treatment of choice for TTP and PHUS whereas delivery is indicated for HELLP syndrome. Once recognized patients with thrombotic microangiopathies should be transferred to tertiary care hospitals where the mother and infant can get adequate treatment.