A Rare Case of Pregnancy-Associated Thrombotic Thrombocytopenic Purpura: Challenges in Diagnosis and Management

Thrombotic thrombocytopenic purpura (TTP) in pregnancy is a rare but potentially life-threatening condition that presents significant diagnostic challenges due to its overlapping features with other pregnancy-related disorders, such as preeclampsia and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. We present the case of a 29-year-old gravida 2 para 1 woman at 35 weeks of gestation who presented with generalized weakness, nausea, and bruising, with laboratory findings indicating thrombocytopenia, microangiopathic hemolytic anemia, and schistocytes on peripheral blood smear. A diagnosis of pregnancy-associated TTP was made after excluding other causes such as preeclampsia. The patient was treated with plasma exchange, and her condition improved, leading to a successful cesarean section at 36 weeks of gestation. The neonatal outcome was favorable. This case highlights the importance of early recognition of TTP in pregnancy, as timely diagnosis and treatment with plasma exchange are critical for both maternal and fetal survival.