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The management of thrombotic thrombocytopenic purpura (TTP) generally includes plasma exchange to raise ADAMTS13 levels and the use of immunosuppression when antibodies to ADAMTS13 are identified. Now, investigators have conducted two trials to measure the effectiveness of these measures in pregnant patients and in those who experience relapse.
Scully and colleagues conducted a prospective study of 35 women presenting with TTP during pregnancy and examined outcomes in 23 with congenital TTP. Fetal loss occurred in 16 of 38 pregnancies, usually in the second trimester prior to diagnosis of the disease. Once TTP was diagnosed, ADAMTS13 levels were closely monitored, and ADAMTS13 was administered using either plasma or an ADAMTS13-containing co…