Pregnancy in a Patient of Glanzmann's Thrombasthenia with Antiplatelet Antibodies

Kashyap, Rajesh; Kriplani, Alka; Saxena, Renu; Takkar, D.; Choudhry, V. P.

doi:10.1111/j.1447-0756.1997.tb00839.x

Cited by 32 publications

(38 citation statements)

References 7 publications

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“…Bleeding before pregnancy was documented for 25/35 (71%) women and in all cases was abnormal. Previous symptoms included epistaxis in 18/25 (72%) [10][11][12][13][14][15]20,23,[26][27][28][29][30][31][32][33][34][35], menorrhagia or prolonged bleeding at menarche in 17/25 (68%) [10,11,13-18, 25,26,28,29,31-35] and gingival bleeding in 11/25 (44%) women [13,18,23,26,27,[29][30][31][33][34][35]. Other symptoms included bleeding hepatic adenomas [13], gastrointestinal tract bleeding [21,31,34] and haemarthrosis [32].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the management and outcomes of pregnancy in Glanzmann thrombasthenia

2011

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Glanzmann Thrombasthenia (GT) is a rare autosomal recessive disorder which usually manifests as severe mucocutaneous bleeding and is caused by deficiency of the platelet glycoprotein IIb-IIIa. Pregnancy in women with GT presents particular challenges as there is increased risk of both maternal and foetal bleeding. To improve understanding and clarify the optimum management of pregnancy in this disorder, we performed a systematic review of the world literature of pregnancy and GT. This identified three single-centre case series of patients with GT that included brief descriptions of women in pregnancy and 31 detailed case reports of 40 pregnancies in 35 women that resulted in 38 live births. Among the detailed case reports, ante-natal bleeding was described in 50% of pregnancies but was usually mild and occurred at mucocutaneous sites. Primary postpartum haemorrhage (PPH) was reported in 34% of pregnancies and secondary PPH in 24%. PPH was frequently severe and occurred up to 20 days after delivery. There was a wide variation in approach to prevention and treatment of PPH but most women received platelet transfusion, sometimes with additional recombinant FVIIa and anti-fibrinolytics. Maternal alloimmunization against platelet antigens was reported in 73% of pregnancies and was associated with four neonatal deaths. These data emphasize the need for multidisciplinary management of pregnancy in women with GT. Delivery plans should recognize the need for prevention and aggressive treatment of PPH and should minimize foetal bleeding risk in pregnancies complicated by alloimmunization.

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Section: Resultsmentioning

confidence: 99%

A systematic review of the management and outcomes of pregnancy in Glanzmann thrombasthenia

2011

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“…The latest modality being used to correct postpartum hemorrhage in these patients is recombinant factor VIIa [2]. Oral prednisolone has also been used to treat secondary PPH in some centers [3].…”

Section: Resultsmentioning

confidence: 99%

Glanzmann’s Thrombasthenia Complicating Pregnancy

Magudapathi

Kannan

2013

J Obstet Gynecol India

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“…The latest modality being used to correct postpartum hemorrhage in these patients is recombinant factor VIIa [13,14]. Oral prednisolone has also been used to treat secondary PPH in some centres [15].…”

Section: Resultsmentioning

confidence: 99%

Glanzmann’s Thrombasthenia Complicating Pregnancy

Magudapathi¹

2012

J Clin Case Rep

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Glanzmann's thrombasthenia is a rare autosomal recessive hemorrhagic disorder caused by abnormal platelet glycoprotein complex (GP IIb-IIIa) presenting with hemorrhagic symptoms. Pregnancy is not uncommon because fertility is not affected but an association is rare. Also delivery often results in haemorrhage. Newborn thrombocytopenia is occasionally severe, but is always transitory. We report a 21-year old primigravida, who underwent vaginal delivery at term with IUGR and Oligohydramnios. Glannzmann's thrombasthenia was characterized by aggregation and this patient went undiagnosed till adolescence until evaluated for puberty menorrhagia which is uncommon. She received single donor platelet transfusion during the intrapartum period along with tranexemic acid. Platelet transfusion may result in alloimmunization and make successive transfusions less effective. We did not use Factor VII in the intrapartum period due to cost and suspected fetal effects. Postnatally she had hematuria settled on the 2 nd day with conservative management. We present this case because of association of Glanzmann's thrombasthenia with IUGR and oligoamnios the only reported case so far.

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Pregnancy in a Patient of Glanzmann's Thrombasthenia with Antiplatelet Antibodies

Cited by 32 publications

References 7 publications

A systematic review of the management and outcomes of pregnancy in Glanzmann thrombasthenia

A systematic review of the management and outcomes of pregnancy in Glanzmann thrombasthenia

Glanzmann’s Thrombasthenia Complicating Pregnancy

Glanzmann’s Thrombasthenia Complicating Pregnancy

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