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Pregnancy complicated by Evan's syndrome.

Z Selçuk Tuncer1, Y Büyükaşik, E Demirtaş

  • 1Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey. zstuncer@hacettepe.edu.tr

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|December 1, 2001
PubMed
Summary

Evan's syndrome in pregnancy is rare. High-dose steroids for this condition may trigger serious complications like disseminated gonococcal infection, preterm labor, and placental abruption.

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Area of Science:

  • Obstetrics and Gynecology
  • Hematology

Background:

  • Evan's syndrome is a rare autoimmune disorder characterized by autoimmune hemolytic anemia and immune thrombocytopenic purpura.
  • Pregnancy presents unique challenges for managing autoimmune conditions due to physiological changes and potential risks to both mother and fetus.

Observation:

  • A 26-year-old pregnant patient was diagnosed with Evan's syndrome.
  • Treatment with high-dose steroid therapy was initiated for Evan's syndrome.
  • The patient subsequently developed signs suggestive of disseminated gonococcal infection.

Findings:

  • The patient experienced preterm labor and abruptio placentae following steroid therapy and suspected disseminated gonococcal infection.
  • Cesarean delivery was performed at 34 weeks gestation after platelet transfusion.

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  • While the infant survived, the mother suffered delayed postpartum hemorrhage.

    • Implications:

    • High-dose steroid therapy in pregnant patients with Evan's syndrome requires careful monitoring for serious infectious and obstetric complications.
    • Management strategies must balance the treatment of Evan's syndrome with the risks of iatrogenic complications during pregnancy.
    • This case highlights the critical need for vigilance regarding potential infections and obstetric emergencies in pregnant patients with autoimmune hematologic disorders.