✅ Thrombocytopenia in pregnancy may be caused by pregnancy-specific and non-pregnancy specific conditions.
✅ Concomitant presence of thrombocytopenia and macroangiopathic hemolytic anemia raises concern for an underlying thrombotic microangiopathy, including HELLP, TTP, HUS or AFLP.
✅ HELLP is a variant of severe preeclampsia.
✅ Suspect a diagnosis of HELLP in a patient with TMA who has:
- Hypertension and proteinuria
- Abnormal liver function tests
- Normal prothrombin time (elevated in AFLP)
- Absence of hypoglycemia (characteristic of AFLP)
✅ Confirm diagnosis of HELLP using one of several classification schemes:
- American College of Obstetricians and Gynecologists
- Tennessee Classification System
- Mississippi Triple-Class System
✅ Treat HELLP with supportive care and delivery within 48 h of presentation.