[Aplastic anaemia associated with pregnancy]

Area of Science:

• Hematology
• Obstetrics & Gynecology
• Immunology

Background:

• Aplastic anemia, a rare bone marrow failure disorder, poses significant risks during pregnancy due to immunosuppression.
• Pregnancy-associated aplastic anemia can lead to severe complications, including hemorrhage and infection, endangering both mother and fetus.

Observation:

• This report details the first case of aplastic anemia in a pregnant woman in Bulgaria, diagnosed at 12-13 weeks gestation.
• Despite multidisciplinary consultations and supportive care including transfusions and methylprednisolone, the patient's condition deteriorated.
• The optimal timing for pregnancy interruption in the first trimester was missed, leading to fatal complications.

Findings:

• The patient succumbed to aplastic anemia, diagnosed as pregnancy-induced.
• The case highlights the critical, often missed, window for intervention in early pregnancy.

Implications:

• Termination of pregnancy in the first trimester is strongly advised for pregnant women diagnosed with aplastic anemia.
• For later-term diagnoses, aggressive supportive care, immunosuppressive therapy (e.g., antithymocyte globulin, cyclosporine), and consideration for bone marrow transplantation are crucial.