How old are you (in years)?
What race do you identify with?
Caucasian/ white.
African American/ black.
Asian
Pacific islander
Native American
Other / Rather not say
What ethnicity do you identify with?
Hispanic or Latino.
Non-Hispanic.
Unknown.
Other / Rather not say
What type of TTP do you have
Acquired or immune
Congenital
Not sure/don't know
At what age were you diagnosed with TTP?
(As close as possible, if you don't remember exactly)
Have any of your family members been diagnosed with TTP?
Yes
No
If yes, what is the relationship of the family member to you? (Father, Mother, Brother, etc.)
Do you also have Systemic Lupus Erythematosus (SLE) or lupus?
Yes
No
Have you ever been pregnant?
Yes
No
How many times were you pregnant before you were diagnosed with TTP?
0 1 2 3 4 5 6+
Were you diagnosed with any medical conditions other than TTP prior to pregnancy? (select all that apply)
Were you pregnant at the time you were first diagnosed with TTP?
Yes
No
Did you have any complications during this pregnancy? (select all that apply)
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
Were you ever treated for TTP during pregnancy?
Yes
No
How many times have you been pregnant since you were diagnosed with TTP?
0 1 2 3 4 5 6 7 8 9+
How many children do you have?
1 2 3 4 5 6 7 8 9+
What was your age at the time of your first pregnancy after your TTP diagnosis?
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
What was your age at the time of your second pregnancy after your TTP diagnosis?
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
What was your age at the time of your third pregnancy after your TTP diagnosis?
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
What was your age at the time of your fourth pregnancy after your TTP diagnosis?
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
What was your age at the time of your fifth pregnancy after your TTP diagnosis?
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
What was your age at the time of your sixth pregnancy after your TTP diagnosis?
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
What was your age at the time of your seventh pregnancy after your TTP diagnosis?
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
What was your age at the time of your eighth pregnancy after your TTP diagnosis?
Were you diagnosed with TTP before this pregnancy, during this pregnancy, or after the pregnancy?
I was diagnosed with TTP before this pregnancy
I was diagnosed with TTP during this pregnancy
I was diagnosed with TTP after this pregnancy
Did you have any complications during this pregnancy?
If other please specify the complications during the pregnancy?
Please select the treatment you received during this pregnancy for TTP?
Was the pregnancy a live birth or miscarriage/Fetal loss?
Live birth
Miscarriage/Fetal loss
How many weeks along were you in the pregnancy before fetal loss
How many weeks did the pregnancy last?
Do you have a hematologist/ TTP doctor?
Yes
No
Were you closely monitored by your TTP doctor/ hematologist with ADAMTS levels and/ or ADAMTS antibodies following TTP remission?
Yes
No
Do you want a pregnancy but have avoided getting pregnant due to fear of TTP relapse?
Yes
No
Has your TTP diagnosis affected your willingness to get into a relationship?
Yes
No
Has your TTP doctor/hematologist advised you to not get pregnant?
Yes
No
Has your doctor discussed strategies/treatments for a safe pregnancy after TTP?
Yes
No
If yes, which of the following have been discussed?