TABLE 1.

Summary of our patient’s clinical course

Gestational age weeks
	Clinical features and outcomes
First pregnancy
13	Presentation with hypertension, stroke and moderate thrombocytopenia. Hereditary TTP suspected. Begin plasma prophylaxisa, every 2 weeks.
17	Normal fetal ultrasound.
22	TTP exacerbation. Intrauterine fetal demise. Subsequently, biallelic ADAMTS13 mutations confirmed diagnosis of hereditary TTP.
Second pregnancy
4	Begin plasma prophylaxis, every 2 weeks.
11	Increase plasma to weekly (approaching the gestational age when complications occurred in her first pregnancy).
31	Increase plasma to twice weekly (blood pressure ↑, platelet count ↓).
32	Preeclampsia with severe features. C-section, healthy infant.

^aEach plasma infusion was 750 mL (12.5 mL/kg).