[Glanzmann's thrombasthenia and pregnancy. Contribution of plasma exchange before scheduled cesarean section].
Glanzmann's thrombasthenia is a thrombopathy which affects primary hemostasis due to a qualitative or quantitative abnormality of membrane glycoproteins IIb-IIIa. The treatment of hemorrhages is usually associated with the transfusion of packed red blood cells and platelet concentrates. If massive allo-immunisation occurs, the transfusion will prove to be inefficient. A case of a cesarean section was scheduled after therapeutic plasmapheresis and platelet transfusions in a massively allo-immunised patient with Glanzmann's thrombasthenia. The plasma exchange made it possible to reduce to trace levels the concentrations of anti-PLA1 and anti-PLA2 antibodies, thus making platelet transfusions hemostatically efficient. The cesarean section was therefore safely performed when the bleeding time was normalized.
Clinique Gynécologique et Obstétricale, Ecole des Sages-Femmes, Hôpital Central, Strasbourg.
M
M
Vivier
A
A
Treisser
M
M
Naett
P
P
Diemunsch
J P
JP
Schmitt
C
C
Waller
M M
MM
Tongio
S
S
Hemmendinger
P
P
Lutz
D000328:Adult; D001791:Blood Platelet Disorders / Q000628:therapy*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D010951:Plasma Exchange; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy*; D013915:Thrombasthenia / Q000628:therapy*
Thrombasthénie de Glanzmann et grossesse. Apport des échanges plasmatiques avant césarienne programmée.