Obstetric Medicine > Volume 2, Number 1 > Pp. 26-29

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Case reports

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

Adi Smolinsky MD   ^*, Michael P Carson MD    , Edwin R Guzman MD   ^*, Angela Ranzini MD   ^*, Joanne Toscano MT (ASCP) (SBB)    and Amar Bukhari MD   

^* Department of Obstetrics and Gynecology, Saint Peter's University Hospital, New Brunswick, NJ, USA; Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA; Department of Laboratory Medicine; Critical Care Medicine, Saint Peter's University Hospital, New Brunswick, NJ, USA

Correspondence to: Michael P Carson, Director of Research/Outcomes, Jersey Shore University Medical Center, Department of Medicine, Ackerman-3, 1945 Route 33, Neptune, NJ 07753, USA Email: MPCarson{at}meridianhealth.com

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 x 10⁹/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.

Key Words: aplastic anaemia • pregnancy • platelet transfusion • refractory • thrombocytopenia

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