Summary of the management of a patient presenting with acute TTP. All women require specialist obstetric review, regular fetal growth scan, and uterine artery Doppler monitoring. On achieving a platelet count of 50 × 10⁹/L, start low-dose aspirin (LDA). Following an acute presentation, low-molecular-weight heparin (LMWH) thromboprophylaxis should be given. HBP, hypertension; LDH, lactate dehydrogenase; LFT, liver function test; MAHA, microangiopathic hemolytic anemia; PET, preeclampsia; PEX, plasma exchange; PI, plasma infusion; TMA, thrombotic microangiopathy.