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

Azam  Zafarbakhsh; Mohadese  Poorpouneh; Samira  Rafiee

doi:10.18502/crcp.v9i2.16922

Azam Zafarbakhsh Isfahan University of Medical Sciences, Isfahan, Iran
Mohadese Poorpouneh Department of Internal Medicine, School of Medicine Isfahan University of Medical Sciences, Iran
Samira Rafiee Department of Obstetrics & Gynecology, School of Medicine, Isfahan University of Medical Sciences, Iran

DOI: https://doi.org/10.18502/crcp.v9i2.16922

Keywords: Glanzmann; Thrombasthenia; Hematuria; Cesarean section

Abstract

Glanzmann’s thrombasthenia (GT) is a rare genetic platelet disorder that leads tobleeding problems in affected individuals. We present a 28-year-old woman withGT who experienced a rare symptom of painless gross hematuria in the last monthof pregnancy. To provide the best care, an interdisciplinary approach was followedby a team of obstetricians and gynecologists, hematologists, neonatologists, andanesthesiologists. The IUGR fetus was delivered by cesarean section and had mildacidosis and thrombocytopenia at birth. Both the baby and the mother were carefullycared for and treated. Hematuria also improved spontaneously within two weeks afterdelivery.Gross hematuria during pregnancy rarely occurs due to the pressure of the presentingpart of the fetus on the mother’s bladder (due to engagement). Aggravation of anyclinical symptoms in pregnant women with GT should alert maternal and fetal healthcare providers to make individualized decisions.