Work

Glanzmann's thrombasthenia in a twin pregnancy: A case report

Year: 2025

Type: article

Abstract: Glanzmann's thrombasthenia (GT) is a rare autosomal recessive bleeding disorder caused by deficient or defective integrin αIIbβ3 on platelets, leading to impaired platelet aggregation. Pregnancy in women with GT poses significant challenges due to the increased risk of bleeding antenatally, intrapartum, and postpartum, as well as potential complications for the neonate, such as neonatal alloimmune thrombocytopenia (NAIT). This case report details the contemporary, multidisciplinary management of a 35-year-old primigravid woman with a dichorionic, diamniotic twin pregnancy and GT which included an elective caesarean section under general anaesthesia performed at 36 + 5 weeks of gestation, with recombinant factor VIIa (NovoSeven) and tranexamic acid (TXA) treatment preoperatively and pre-emptive uterotonic administration intraoperatively to minimise haemorrhage. Postpartum management included a seven-week course of TXA. This case highlights the importance of a proactive, multidisciplinary care plan to optimize pregnancy outcomes in women with GT, with a focus on minimizing the risk of severe haemorrhage. • Pregnancy in women with Glanzmann's thrombasthenia poses increased risks of bleeding antenatally, intrapartum, and postpartum, and potential neonatal complications such as neonatal alloimmune thrombocytopenia. • Dichorionic diamniotic twin pregnancies further increase postpartum bleeding risks in these women. • A proactive approach to minimise the risk of severe haemorrhage should include a multidisciplinary team including senior clinicians, haemorrhage prophylaxis, and enhanced post-operative monitoring. • Novoseven (recombinant factor VIIa) and tranexamic acid can reduce perioperative bleeding risk.

Source: Case Reports in Women s Health

DOI: 10.1016/j.crwh.2025.e00697

Authors: Vicky X. Xu, Shaun P. Brennecke

Institutions: Royal Women's Hospital, The University of Melbourne

Language: English

Topic: Platelet Disorders and Treatments

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,080