Successful delivery in a female with thrombotic thrombocytopenic purpura.
A 28-year-old female, who suffered from thrombotic thrombocytopenic purpura (TTP) in the 14th week of her first pregnancy, recovered after a plasma exchange followed by an induced abortion. From six months after the abortion, she no longer required plasma infusions every 3-4 weeks to prevent a relapse of TTP manifested as thrombocytopenia, and complete remission continued until her next pregnancy. In her second pregnancy, she had an immediate relapse of TTP and responded to plasma infusion until the 24th week. However, the TTP gradually became resistant to plasma infusion, and developed into toxemia with edema, hypertension and proteinuria in the 27th week. Although the TTP was alleviated by the infusion of large amounts of plasma, the placenta failed as the result of numerous white infarcts. She delivered a 948 g live baby by cesarean section in the 33rd week. The baby had transient thrombocytopenia but did not suffer from TTP. The mother required plasma infusions every 3-4 weeks for about five months, and she has continued in remission.
Koyama
T
T
Second Department of Internal Medicine, Hyogo College of Medicine, Japan.
Oura
Y
Y
Kakishita
E
E
Nagai
K
K
Matsuda
T
T
Taira
S
S
Isojima
S
S
D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010922:Placenta Diseases / Q000209:etiology; D010951:Plasma Exchange; D011225:Pre-Eclampsia / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000097:blood / Q000628:therapy*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000097:blood / Q000150:complications / Q000628:therapy*