Abstract
Glanzmann’s thrombasthenia is an inherited hemorrhagic disorder characterized by a severe reduction in, or absence of, platelet aggregation in response to multiple physiologic agonists due to qualitative or quantitative abnormalities of platelet glycoprotein IIb-IIIa. Glanzmann’s thrombasthenia is characterized by potentially major mucocutaneous bleeding and prolonged bleeding time. Platelet counts, platelet morphology, prothrombin, and activated thromboplastin times are all within normal ranges in patients with Glanzmann’s thrombasthenia. Pregnancy and delivery are rare in Glanzmann thrombasthenia patients and have been associated with immediate postpartum hemorrhage. We describe the peripartum management of a 31-year-old primipara with Glanzmann’s thrombasthenia who underwent spontaneous vaginal delivery. Four units of single-donor platelets, two units of packed red blood cells, 36 µg/kg recombinant human coagulation Factor VIIa (rFVIIa) were given during peripartum management.
References
1 Awidi AS: Delivery of infants with Glanzmann thrombasthenia and subsequent blood transfusion requirements: a follow-up of 39 patients. Am J Hematol40 (1992) 110.1002/ajh.2830400102Search in Google Scholar
2 George JN, JP Caen, AT Nurden: Glanzmann’s thrombasthenia: the spectrum of clinical disease. Blood75 (1990) 1383Search in Google Scholar
3 Ito K, H Yoshida, H Hatoyama, H Matsumoto, C Ban, et al.: Antibody removal therapy used successfully at delivery of a pregnant patient with Glanzmann’s thrombasthenia and multiple anti-platelet antibodies. Vox Sang61 (1991) 40Search in Google Scholar
4 Kashyap R, A Kriplani, R Saxena, D Takkar, VP Choudhry: Pregnancy in a patient of Glanzmann’s thrombasthenia with antiplatelet antibodies. J Obstet Gynaecol Res23 (1997) 247Search in Google Scholar
5 Kato A: The biologic and clinical spectrum of Glanzmann’s thrombasthenia: implications of integrin alpha IIb beta 3 for its pathogenesis. Crit Rev Oncol Hematol26 (1997) 110.1016/S1040-8428(97)00011-5Search in Google Scholar
6 Laursen B, SE Jacobsen, E Taaning, N Grunnet: Transfusion problems in patients with Glanzmann’s thrombasthenia. Eur J Hematol49 (1992) 143Search in Google Scholar
7 Monrigal C, P Beurrier, FJ Mercier, C Boyer-Neumann, P Gillard: Glanzmann’s thrombasthenia and pregnancy: a case and review of the literaturex. Ann Fr Anesth Reanim22 (2003) 826Search in Google Scholar
8 Monroe DM, M Hoffman, GA Allen, HR Roberts: The factor VII-platelet interplay: effectiveness of recombinant factor VIIa in the treatment of bleeding in severe thrombocytopathia. Semin Thromb Hemost26 (2000) 373Search in Google Scholar
9 Perutelli P, PG Mori: Biochemical and molecular basis of Glanzmann’s thrombasthenia. Haematologica77 (1992) 421Search in Google Scholar
10 Pomili G, F Servidio, R Vezza, S Ricotta, P Gresele, et al.: Pregnancy and labor in a primigravida with Glanzmann’s thrombasthenia. Minerva Ginecol46 (1994) 129Search in Google Scholar
11 Poon MC, R d’Oiron, I Hann, C Negrier, L de Lumley, et al.: Use of recombinant factor VIIa (NovoSeven) in patients with Glanzmann thrombasthenia. Semin Hematol38 (2001) 21Search in Google Scholar
12 Reichert N, U Seligsohn, B Ramot: Clinical and genetic aspects of Glanzmann’s thrombasthenia in Israel: report of 22 cases. Thromb Diath Haemorrh34 (1975) 806Search in Google Scholar
13 Sherer DM, R Lerner: Glanzmann’s thrombasthenia in pregnancy: a case and review of the literature. Am J Perinatol16 (1999) 297Search in Google Scholar
14 Sundqvist SB, IM Nilsson, L Svanberg, S Cronberg: Pregnancy and parturition in a patient with severe Glanzmann’s thrombasthenia. Scand J Haematol27 (1981) 159Search in Google Scholar
15 Vivier M, A Treisser, M Naett, P Diemunsch, JP Schmitt, et al.: Glanzmann’s thrombasthenia and pregnancy. Contribution of plasma exchange before scheduled cesarean section. J Gynecol Obstet Biol Reprod18 (1989) 507Search in Google Scholar
16 Vuckovic SA. Glanzmann’s thrombasthenia revisited. J Emerg Med14 (1996) 29910.1016/0736-4679(96)00024-8Search in Google Scholar
© Walter de Gruyter