Background: Thrombotic thrombocytopenic purpura is a rare disease. However, in pregnant women it occurs more frequently. Thrombotic thrombocytopenic purpura may be a severe condition for both mother and fetus.
Case: This is a case of severe but temporary fetal heart rate abnormalities in a pregnancy complicated by thrombotic thrombocytopenic purpura. There was a remarkably good outcome despite indications of an impaired fetal condition for a period of at least 48 hours.
Conclusion: Based on the literature regarding transient severe neurological symptoms in adults with thrombotic thrombocytopenic purpura, we hypothesize that the transient fetal heart rate abnormalities were most likely due to reversible microthrombi in the placenta.