title: Aplastic anaemia in pregnancy with severe thrombocytopenia refractory to platelet transfusion: a case and management plan.
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.
authors: Department of Obstetrics and Gynecology , Saint Peter's University Hospital , New Brunswick, NJ , USA.
authors: Adi
authors: A
authors: Smolinsky
authors: Department of Medicine , Jersey Shore University Medical Center , Neptune, NJ , USA.
authors: Michael P
authors: MP
authors: Carson
authors: Department of Obstetrics and Gynecology , Saint Peter's University Hospital , New Brunswick, NJ , USA.
authors: Edwin R
authors: ER
authors: Guzman
authors: Department of Obstetrics and Gynecology , Saint Peter's University Hospital , New Brunswick, NJ , USA.
authors: Angela
authors: A
authors: Ranzini
authors: Department of Laboratory Medicine.
authors: Joanne
authors: J
authors: Toscano
authors: Critical Care Medicine , Saint Peter's University Hospital , New Brunswick, NJ , USA.
authors: Amar
authors: A
authors: Bukhari
keywords: aplastic anaemia; platelet transfusion; pregnancy; refractory; thrombocytopenia