TABLE 1.

Etiologies of severe thrombocytopenia and microangiopathic hemolytic anemia occurring together during pregnancy

Disorders that only occur during pregnancy

Preeclampsia with severe featuresa

Eclampsia

Hemolysis, elevated liver function tests, low platelets (HELLP) syndrome

Acute fatty liver of pregnancy (AFLP)

Disorders that can occur in all women

Thrombotic thrombocytopenic purpura (TTP) Acquired, autoimmine Hereditary

Severe hypertension

Complement-mediated thrombotic microangiopathy (C-TMA, also described as atypical hemolytic-uremic syndrome, aHUS)

Antiphospholipid syndrome

Drug-induced thrombotic microangiopathy (DITMA)

Note: This table lists the disorders that can present with both of severe thrombocytopenia (platelet count <100 000/μL) and microangiopathic hemolytic anemia. We focus on the disorders highlighted by italics, because their pathogenesis and clinical features overlap. In the text we consolidate preeclampsia with severe features, eclampsia, and the HELLP syndrome into a single term, PE/HELLP.

^aThe American College of Obstetricians and Gynecologists has replaced the term “severe preeclampsia” with the term “preeclampsia with severe features”.