Glanzmann’s Thrombasthenia During Pregnancy: Case Report and Literature Review

Glanzmann’s thrombasthenia (GT) is an uncommon congenital disease due to a qualitative or quantitative anomaly of the glycoprotein complex GPIIb/IIIA, resulting in a defective platelet aggregation. In pregnant women, this bleeding disorder could lead to severe haemorrhages and may require aggressive treatment with a combined therapy, including platelet concentrates, anti-fibrinolytics and recombinant activated coagulation factor VII (rFVIIa). Therefore, a scheduled plan for obstetric and haematological management should be set in advance. Close clinical observation, laboratory monitoring and immediate access to pro-haemostatic therapies are essential, leading to lower rates of postpartum haemorrhage. A 35-year-old White woman with Glanzmann’s thrombasthenia was followed during pregnancy. A multidisciplinary meeting including gynaecologists, obstetrics, haematologists and anaesthesiologists was arranged for the management of unexpected antepartum haemorrhages, method of delivery and postpartum care. The primary aim of this case report was to evaluate the management of Glanzmann’s thrombasthenia during pregnancy, with particular emphasis on the current management of the haemorrhages and the method of delivery, in order to ensure optimal maternal and foetal outcomes. Our study confirms that pregnancy, delivery and postpartum care should be managed by a multidisciplinary team in a specialized centre, in order to guarantee a proper treatment with a combined therapy.