Affiliation:
1. Department of Pathology, Molecular, and Cell‐Based Medicine Icahn School of Medicine at Mount Sinai New York New York USA
2. Department of Obstetrics, Gynecology, and Reproductive Medicine Mount Sinai Hospital, Icahn School of Medicine New York New York USA
3. Division of Hematology/Oncology, Department of Medicine Icahn School of Medicine at Mount New York New York USA
Abstract
AbstractBackgroundGlanzmann thrombasthenia (GT) is a rare, autosomal recessive disorder of platelet glycoprotein IIb‐IIIa receptors. Pregnant patients with GT are at increased risk of maternal and fetal bleeding. There is a paucity of literature on the peripartum management of patients.Case DescriptionWe present the antepartum through the postpartum course of a patient with GT who was managed by a multidisciplinary approach that included communication across maternal‐fetal medicine, hematology, transfusion medicine, and anesthesiology services. In addition to routine prepartum obstetric imaging and hematologic laboratory studies, we proactively monitored the patient for anti‐platelet antibodies every 4–6 weeks to gauge the risk for neonatal alloimmune thrombocytopenia. Furthermore, we prioritized uterotonics, tranexamic acid, and transfusion of HLA‐matched platelets to manage bleeding for mother and fetus intrapartum through the postpartum periods.ConclusionTo date, there are limited guidelines for managing bleeding or preventing alloimmunization during pregnancy in patients with GT. Here, we present a complex case with aggressive management of bleeding prophylactically for the mother while serially monitoring both mother and fetus for peripartum bleeding risks and events. Moreover, future studies warrant continued evaluation of these approaches to mitigate increased bleeding risks in subsequent pregnancies.
Subject
Hematology,Immunology,Immunology and Allergy