Thrombotic Microangiopathy in Pregnancy: Challenges and Advances

HemeTalks: Conversations in Hematology Education

Join us for an insightful discussion on thrombotic microangiopathy (TMA) in pregnancy with Drs. Richard Burwick and Shruti Chaturvedi as we navigate the complexities of diagnosing and managing hypertensive disorders in pregnancy. These conditions often present overlapping clinical and laboratory features, making timely and accurate intervention challenging. Through the case of a 32-year-old woman at 30 weeks' gestation with severe hypertension, headache, and new-onset thrombocytopenia, we will explore key diagnostic considerations, the distinguishing features of preeclampsia with severe features, Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome, and TMA, and the best strategies for optimizing maternal and fetal outcomes in these high-risk situations. This episode offers practical, evidence-based insights to enhance the recognition and management of pregnancy-related TMA and hypertensive disorders.

Learning Objectives:

1. Differentiate between preeclampsia with severe features, HELLP syndrome, and TMA using clinical and laboratory findings.
2. Identify the most appropriate diagnostic tests to confirm the underlying etiology in pregnant patients with hypertension and thrombocytopenia.
3. Discuss immediate and long-term management strategies, including when to initiate delivery and the role of plasma exchange in suspected TMA.