Therapeutic Plasma Exchange and Pregnancy: A Case Report and Guidelines for Performing Plasma Exchange in a Pregnant Patient

Therapeutic plasma exchange (TPE) has been demonstrated to be of significant clinical value in a number of diseases and conditions, with well-established guidelines and recommendations. However, technical support in providing this procedure for pregnant patients is largely absent from these recommendations, leaving therapeutic apheresis practitioners without guidance to safely and adequately treat appropriate conditions in this important patient population. Here, we describe our experience in treating a 35-year-old pregnant patient with relapsing-remitting multiple sclerosis with TPE. Additionally, we outline the principle considerations when developing her treatment plan, and we provide recommendations for apheresis practitioners when performing TPE in pregnant patients. (C) 2016 Wiley Periodicals, Inc.