Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a known risk in pregnancies complicated by Glanzmann’s thrombasthenia, a rare bleeding disorder that affects platelet function, and a recent case report published in Case Reports in Women’s Health highlighted how a well-planned approach can improve outcomes.
The case report described a 35-year-old woman with Glanzmann thrombasthenia who physicians helped to safely deliver twins via cesarean section while minimizing bleeding risks for both her and her babies.
Because Glanzmann’s thrombasthenia prevents platelets from clotting properly, pregnant women with this condition face a high risk of excessive bleeding, which can complicate delivery and postpartum recovery. In this case, a team of maternal-fetal medicine, hematology, and anesthesiology specialists worked together to develop a safe delivery plan.
Since spinal anesthesia was too risky, the mother underwent a planned C-section under general anesthesia at 36 weeks and 5 days. To reduce bleeding, she received special clotting medications, including recombinant factor VIIa and tranexamic acid. These measures helped control blood loss to 400 mL—remarkably low given her condition.
FNAIT, a condition where the mother’s immune system attacks the baby’s platelets, is a well-known complication of Glanzmann’s thrombasthenia pregnancies. Because of this, both twins were closely monitored. One baby developed mild thrombocytopenia on the second day after birth but recovered without treatment. The other baby maintained a normal platelet count. Both had brief breathing difficulties but were otherwise healthy.
Read more about FNAIT causes and risk factors
After delivery, the mother received extended treatment to prevent delayed postpartum bleeding, including seven weeks of tranexamic acid. Her recovery was smooth, with only minor bruising and nosebleeds that resolved on their own. Her blood levels remained stable, and she avoided platelet transfusions, which can lead to immune complications and make future bleeding treatments more difficult.
Sign up here to get the latest news, perspectives, and information about FNAIT sent directly to your inbox. Registration is free and only takes a minute.
