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Case Studies | Anaesthesiology | India | Volume 12 Issue 4, April 2023

Anaesthetic Management in a Parturient with Thrombotic Thrombocytopenic Purpura (TTP) for Emergency Caesarean Section

Sudhahasini Mishra | Antara Tembhe | Kshitija Nirmal | Syama S.

Abstract: Introduction: TTP is a rare and life threatening condition characterized by microangiopathic hemolyticanemia, severe thrombocytopenia and organ ischemia. A 25 - year old pregnant patient at 30 weeks of gestation was posted for emergency lscs in view of non reassuring intrapartum monitoring. Patient was a known case of congenital TTP. She was being treated with Inj. LMWH and 4 units of FFP transfusion 4 times a week since the start of pregnancy. She was also diagnosed with preeclampsia in the current pregnancy and was on tab. labetalol. Patient?s starvation status was 3 hours at the time of being taken in for surgery. Laboratory investigations revealed thrombocytopenia. Informed consent was taken. General anaesthesia was administered to the patient. A male neonate was delivered. Result: The surgery was completed in 1.10 hours. Blood loss was approximately 700ml. Patient was extubated successfully and recovery was uneventful. Conclusion: As this patient was prone for thrombocytopenia and was on LMWH but had an inadequate starvation, weighing the risk benefit ratio of general anaesthesia over regional anaesthesia, general anaesthesia is preferred over regional anaesthesia.

Keywords: TTP, thrombotic thrombocytopenic purpura, LSCS, lower segment caesarean section, LMWH, low molecular weight heparin, FFP, fresh frozen plasma

Edition: Volume 12 Issue 4, April 2023,

Pages: 769 - 770