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Vol. 43. Núm. S3.
Páginas S40 (Novembro 2021)
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Vol. 43. Núm. S3.
Páginas S40 (Novembro 2021)
PP 19
Open Access
BLEEDING MANAGEMENT DURING DELIVERY AND POSTPARTUM PERIOD IN GLANZMANN THROMBASTHENIA: EXPERIENCES FROM TWO CASES
Visitas
1176
Özden ÖZLÜK1, Mustafa Murat ÖZBALAK1, Tarık Onur TİRYAKİ1, Sevgi KALAYOĞLU BEŞIŞIK1, Tuba SARAÇ SİVRİKOZ2
1 İstanbul Medical Faculty, Hematology
2 İstanbul Medical Faculty, Gynecology and Obstetrics
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Vol. 43. Núm S3
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Objective

Glanzmann thrombasthenia (GT) is a hereditary bleeding disorder. The platelets lack αIIbβ3integrin and fail to aggregate. Pregnancy can also lead to isoantibody formation when fetal cells with β3integrins pass into the circulation of a mother lacking them; a consequence is neonatal thrombocytopenia and a high risk of mortality. We here present our experience with two GT patients, in which rFVIIa was our choice for bleeding prophylaxis and/or control during delivery and postpartum period.

Case report

Case 1: A 28-year-old woman with GT was hospitalized. She was on 38th gestational week (GW). Vaginal delivery was completed with rFVIIa prophylaxis. Postpartum 5th day rFVIIa stopped. The patient discharged with a minimal vaginal bleeding. Postpartum10th day, she developed severe bleeding. GT seemed to be the only related factor. rFVIIa restarted with tranexamic acid and misoprostol. Two apheresis units of platelets were transfused. That time, rFVIIa continued 7 days.

Methodology

Case 2: A 26-year-old woman with GT developed hematuria on 30th GW. No urinary system pathology was found. With. rFVIIa treatment, hematuria was ceased. On 39th GW, during labor she developed massive bleeding. As urgent management, 8 random units of platelet and 5 units of packed red blood cell were transfused with local vaginal compress. rFVIIa treatment was initiated. On 10th days of rFIIa with minimal vaginal bleeding the patient was discharged from the hospital.

Results

In both of the patients, no major neonatal bleeding problem was experienced.

Conclusion

GT patients are at risk for heavy bleeding during labor, deliver or postpartum. Platelet transfusion is simple and easy option for bleeding control. In alloimmunized patients pooled platelet should be used. The use of rFVIIa appears to be safe and relatively effective.

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Hematology, Transfusion and Cell Therapy
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