Perioperative Platelet Transfusion Strategies and Multidisciplinary Collaboration Experience in Glanzmann
Xue Cui1, Nuowei Ji1, Shengnan Wang1
1Department of Gynecology and Obstetrics, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, 116023, People's Republic of China.
Objective:
To explore multidisciplinary peripartum management strategies and clinical implications for Glanzmann thrombasthenia (GT) caused by ITGA2B gene variation during pregnancy.
Case Presentation:
A 33-year-old woman at 38+ 5weeks of gestation, diagnosed with GT, was confirmed with biallelic pathogenic ITGA2B mutations (chr17:42452041 and chr17:42,457,372). There was no history of consanguineous marriage in the past three generations of her family. Coagulation dysfunction was observed during pregnancy (fibrinogen: 2.69 g/L; thromboelastography (TEG) maximum clot strength: 12 mm). A multidisciplinary team (MDT) recommended preoperative transfusion of 3 therapeutic doses of platelets and 10 units of cryoprecipitate, with dynamic TEG monitoring showing improved clot strength (post-transfusion maximum clot strength: 29.2 mm). A cesarean section delivered a healthy male infant (3455 g, Apgar score 10). Intraoperative bleeding (900 mL) and postoperative incisional oozing were controlled with compression bandages and platelet transfusion. Both mother and infant had favorable outcomes, with the incision achieving Grade II/A healing.
Conclusion:
Individualized coagulation regulation, multidisciplinary collaboration, dynamic TEG-guided platelet transfusion, and comprehensive postoperative hemostatic management are critical for GT with pregnancy. This case provides practical insights into peripartum care for GT patients.
Related Concept Videos
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:29Venous Thrombosis III: Interprofessional Care
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...