Gross Hematuria Following Fetal Head Engagement in a Pregnant Woman with Glanzman Syndrome

Abstract

Glanzmann’s thrombasthenia (GT) is a rare genetic platelet disorder that leads to bleeding problems in affected individuals. We present a 28-year-old woman with GT who experienced a rare symptom of painless gross hematuria in the last month of pregnancy. To provide the best care, an interdisciplinary approach was followed by a team of obstetricians and gynecologists, hematologists, neonatologists, and anesthesiologists. The IUGR fetus was delivered by cesarean section and had mild acidosis and thrombocytopenia at birth. Both the baby and the mother were carefully cared for and treated. Hematuria also improved spontaneously within two weeks after delivery. Gross hematuria during pregnancy rarely occurs due to the pressure of the presenting part of the fetus on the mother’s bladder (due to engagement). Aggravation of any clinical symptoms in pregnant women with GT should alert maternal and fetal health care providers to make individualized decisions.

Keywords

• Glanzmann
• Thrombasthenia
• Hematuria
• Cesarean section