Thrombotic thrombocytopenic purpura in pregnancy

A 20 week primigravida with intrauterine fetal death and the rare occurrence of thrombotic thrombocytopenic purpura (TTP) in pregnancy is presented. Aprotinin has been used to overcome uterine inertia non-responsive to oxytocin stimulation. TTP was successfully treated with repeated plasmaphereses. The literature is briefly reviewed and the complexity and importance of the differential diagnosis specific to the pregnant patient is discussed.