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Eur J Obstet Gynecol Reprod Biol. 2003 Dec 10;111(2):146-52.

Thrombotic thrombocytopenic purpura: medical and biological monitoring of six pregnancies.

Author information

1
Département d'anesthésie réanimation I, CHRU Lille, 2 avenue Oscar Lambret, 59037 Lille Cedex, France. asducloy@chru-lille.fr

Abstract

BACKGROUND:

Thrombotic thrombocytopenic purpura (TTP) is a rare cause of severe thrombocytopenia in pregnancy.

METHODS:

Six pregnancies in five patients with TTP were followed prospectively over 5 years. Ultralarge von Willebrand factor (ULvWF) multimers and cleaving protease (cp) levels were measured.

RESULTS:

TTP relapsed, complicating four of the six pregnancies. Of three patients who relapsed, two had complete or partial vWF-cleaving protease (vWF-cp) deficiency, and one had a normal vWF-cleaving protease level. In all three we found abnormal UL multimers. The two women who did not relapse had normal vWF-cleaving protease level and an absence or loss of UL multimers.

CONCLUSIONS:

Pregnant patients with a history of TTP must be followed in a tertiary obstetric unit with plasmapheresis available. Influence of vWF-cleaving protease and vWF multimeric abnormalities on TTP relapsing during pregnancy has to be evaluated in a further multicentre study.

PMID:
14597242
DOI:
10.1016/s0301-2115(03)00199-4
[Indexed for MEDLINE]

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