Abstract
A 28-year-old female, who suffered from thrombotic thrombocytopenic purpura (TTP) on the 14th week of her first pregnancy, recovered by plasma exchange, that was followed by artificial abortion. Six months after the abortion, she no longer required plasma infusion every 3∼4 weeks for a relapse of TTP manifested thrombocytopenia, and continued complete remission for the next 6 months.
In her second pregnancy, she had a immediate relapse of TTP and responded to plasma infusion until the 24th week. But, the TTP gradually became resistant to plasma infusion, and developed into toxemia with edema, hypertention and proteinuria in the 27th week. Although the TTP was alleviated by infusion of large amounts of plasma, the placental function changed irreversibly with white infarction, without response to plasma exchange. She delivered a 948 g live baby by cesarean section in 33th week. The baby had transient thrombocytopenia induced by platelet associated antibodies from the mother, but did not suffer from TTP.
The pregnancy might be one of the causative and worsening factors of TTP, and the toxemia with numerous placental infarcts might be developed by recurring TTP in this patient.
