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May 18, 1963

Thrombotic Thrombocytopenic Purpura in Pregnancy

Author Affiliations

New York

From the departments of laboratories, medicine, and obstetrics, the Bronx Hospital.; Dr. Block is a Fellow of the National Heart Institute, National Institutes of Health.

JAMA. 1963;184(7):587-590. doi:10.1001/jama.1963.73700200008025a

THROMBOTIC THROMBOCYTOPENIC PURPURA (TTP) is being diagnosed with increasing frequency. Five cases have been reported in which the disease occurred as a complication of pregnancy.1-4 We are here presenting a synopsis of these cases and are adding a sixth case together with a discussion of diagnosis and management.

Report of a Case  On Jan 20, 1961, a 28-yr-old pregnant woman, Gravida 6, Para 4, whose expected date of confinement was Feb 20, came to The Bronx Hospital in active labor. Fifteen minutes after admission a 4 lb 6 oz (2.0 kg) girl was delivered spontaneously. Intrapartum bleeding was estimated at less than 150 cc. The only notable signs at this time were pallor (Table 1) and a blood pressure of 140/90 mm Hg. A blood transfusion had to be discontinued after 800 cc because of a chill and vomiting. Rectal temperature was 100 F (37.8 C) and pulse rate

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