Lian E C, Byrnes J J, Harkness D R
Am J Hematol. 1984 Apr;16(3):287-91. doi: 10.1002/ajh.2830160310.
A 21-year-old primigravida in her 20th week of pregnancy developed TTP. She was managed with weekly or semiweekly plasma infusions and delivered a healthy 1.6 kg baby 2 weeks prior to the expected date of delivery. After delivery she continued to have active TTP with thrombocytopenia which responded repeatedly to plasma infusion though their frequency gradually decreased to about one unit every 3-4 weeks. Three years after the birth of the first child she conceived again and was easily managed with repeated plasma infusions although the frequency and amount of plasma required to prevent thrombocytopenia were increased. She delivered a normal 3.4 kg term baby after which she again had a decreased plasma requirement. This is the first report of a woman with 5 years of active TTP managed with plasma alone. She experienced two pregnancies in which both mother and infant survived. We believe that the use of plasma in the management of TTP during pregnancy will improve the survival rate of both mother and infant. At the time of second birth, the platelet count was low in the mother but normal in the baby. This suggests that the platelet depressing factor of this patient does not cross the placental barrier.
一名21岁的初产妇在怀孕20周时患上了血栓性血小板减少性紫癜（TTP）。她接受了每周或每两周一次的血浆输注治疗，并在预产期前2周生下了一个健康的1.6千克婴儿。产后她仍患有活动性TTP并伴有血小板减少，尽管血浆输注频率逐渐降至每3 - 4周约1个单位，但血小板减少情况对血浆输注反复有反应。第一个孩子出生三年后她再次怀孕，虽然预防血小板减少所需的血浆频率和量有所增加，但通过反复血浆输注很容易进行管理。她足月产下了一个正常的3.4千克婴儿，之后血浆需求量再次减少。这是首例仅通过血浆治疗活动性TTP达5年的女性病例报告。她经历了两次妊娠，母婴均存活。我们认为，孕期使用血浆治疗TTP将提高母婴存活率。第二次分娩时，母亲血小板计数低，但婴儿血小板计数正常。这表明该患者的血小板抑制因子不会穿过胎盘屏障。
