Skip to main content Accessibility help
Hostname: page-component-848d4c4894-tn8tq Total loading time: 0 Render date: 2024-06-17T20:31:57.606Z Has data issue: false hasContentIssue false

Chapter 53 - Thrombotic Thrombocytopenic Purpura in Pregnancy

from Section 9 - Hematologic Conditions in Pregnancy

Published online by Cambridge University Press:  23 February 2023

Amira El-Messidi
McGill University, Montréal
Alan D. Cameron
University of Glasgow
Get access


During your call duty, a healthy 32-year-old primigravida at 22+3 weeks’ gestation, confirmed by first-trimester sonography, presents to the obstetrics emergency assessment unit of your hospital center with new-onset, asymptomatic port-wine-colored urine with chills and an oral temperature of 39.1°C at home; she also notes a two-day history of headache, now accompanied by visual changes. Your obstetric trainee informs you that clinical history is not suggestive of an infectious etiology, although comprehensive investigations are pending. She has no obstetric complaints, and fetal viability was ascertained upon presentation. Routine prenatal laboratory investigations, aneuploidy screening, and fetal morphology survey were unremarkable. The laboratory urgently notifies you that the platelet concentration is 12 × 109/L, confirmed on manual count; other requested laboratory tests are in progress.

OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
, pp. 680 - 689
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Suggested Readings

Battinelli, EM. TTP and pregnancy. Blood. 2014;123(11):16241625.CrossRefGoogle ScholarPubMed
Fyfe-Brown, A, Clarke, G, Nerenberg, K, et al. Management of pregnancy-associated thrombotic thrombocytopenia purpura. AJP Rep. 2013;3(1):4550.CrossRefGoogle ScholarPubMed
Jiang, Y, McIntosh, JJ, Reese, JA, et al. Pregnancy outcomes following recovery from acquired thrombotic thrombocytopenic purpura. Blood. 2014;123(11):16741680.CrossRefGoogle ScholarPubMed
Keiser, SD, Boyd, KW, Rehberg, JF, et al. A high LDH to AST ratio helps to differentiate pregnancy-associated thrombotic thrombocytopenic purpura (TTP) from HELLP syndrome. J Matern Fetal Neonatal Med. 2012;25(7):10591063.CrossRefGoogle ScholarPubMed
Pourrat, O, Coudroy, R, Pierre, F. Differentiation between severe HELLP syndrome and thrombotic microangiopathy, thrombotic thrombocytopenic purpura and other imitators. Eur J Obstet Gynecol Reprod Biol. 2015;189:6872.CrossRefGoogle ScholarPubMed
Savignano, C, Rinaldi, C, De Angelis, V. Pregnancy associated thrombotic thrombocytopenic purpura: Practical issues for patient management. Transfus Apher Sci. 2015;53(3):262268.CrossRefGoogle ScholarPubMed
Scully, M, Thomas, M, Underwood, M, et al. Thrombotic thrombocytopenic purpura and pregnancy: presentation, management, and subsequent pregnancy outcomes. Blood. 2014;124(2):211219.CrossRefGoogle ScholarPubMed
Vesely, SK. Life after acquired thrombotic thrombocytopenic purpura: morbidity, mortality, and risks during pregnancy. J Thromb Haemost. 2015;13(Suppl 1):S216S222.CrossRefGoogle ScholarPubMed
von Auer, C, von Krogh, AS, Kremer Hovinga, JA, et al. Current insights into thrombotic microangiopathies: thrombotic thrombocytopenic purpura and pregnancy. Thromb Res. 2015;135(Suppl 1):S30S33.CrossRefGoogle ScholarPubMed
Zheng, XL, Vesely, SK, Cataland, SR, et al. ISTH guidelines for treatment of thrombotic thrombocytopenic purpura. J Thromb Haemost. 2020;18(10):24962502.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the or variations. ‘’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats