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Case Reports
. 2009 Mar;2(1):26-9.
doi: 10.1258/om.2008.080035. Epub 2009 Mar 1.

Aplastic anaemia in pregnancy with severe thrombocytopenia refractory to platelet transfusion: a case and management plan

Adi Smolinsky  1 , Michael P Carson  2 , Edwin R Guzman  1 , Angela Ranzini  1 , Joanne Toscano  3 , Amar Bukhari  4
Affiliations
Case Reports

Aplastic anaemia in pregnancy with severe thrombocytopenia refractory to platelet transfusion: a case and management plan

Adi Smolinsky et al. Obstet Med. 2009 Mar.

Abstract

Aplastic anaemia is a rare haematological disorder during pregnancy, which when complicated by severe thrombocytopenia poses a significant maternal risk. A woman with aplastic anaemia and a platelet (PLT) count of 11 × 10(9)/L refractory to PLT transfusion required caesarean delivery. Proactive planning by a multidisciplinary team, large volume PLT transfusion prior to surgery and postoperative uterine artery embolization resulted in avoidance of mortality. Maternal preferences should be discussed in detail due to the high risk of maternal morbidity and mortality associated with severe aplastic anaemia. This report outlines a management plan to address the medical and ethical issues faced when caring for a pregnant patient with severe aplastic anaemia and severe thrombocytopenia. We credit the good outcome to our proactive multidisciplinary approach.

Keywords: aplastic anaemia; platelet transfusion; pregnancy; refractory; thrombocytopenia.

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