Inherited Platelet Disorders During Pregnancy and Delivery: Overview of Management Strategies and Emerging Therapeutic Considerations

TL;DR

This paper reviews how inherited platelet disorders affect pregnancy and delivery, highlighting the need for better management strategies to reduce bleeding risks for mothers and babies.

Contribution

The paper provides a comprehensive overview of management strategies and emerging therapies for inherited platelet disorders during pregnancy.

Findings

Individuals with IPD face increased bleeding risks during labor and postpartum.

Severe IPDs like Glanzmann thrombasthenia often require transfusions during delivery.

Fetuses may also be affected, increasing neonatal bleeding risks.

Abstract

Inherited platelet disorders (IPDs) comprise a heterogeneous group of rare conditions that present particular challenges during pregnancy, with bleeding risk increasing during labor and the immediate postpartum period. These disorders require coordinated, multidisciplinary management to mitigate maternal and neonatal bleeding risk. Although data remains limited, individuals with IPD, including Bernard–Soulier syndrome, Glanzmann thrombasthenia, MYH9-related disorders, Hermansky–Pudlak syndrome, and platelet storage pool disorders, are at an increased risk for obstetrical bleeding, with the degree of risk varying by underlying diagnosis. In severe inherited platelet disorders such as Glanzmann thrombasthenia, peripartum hemorrhage is common, with up to half of the deliveries in some series requiring red cell or platelet transfusion. Because these conditions are congenital, the fetus may also be affected, placing neonates at risk for serious bleeding complications, including intracranial hemorrhage, although available data is limited. Despite the considerable morbidity and mortality risk associated with inherited platelet disorders, management strategies during pregnancy and delivery remain poorly defined. This stands in contrast to other bleeding disorders, such as factor deficiencies, for which multiple therapeutic approaches have been evaluated in the peripartum setting. In this review, we summarize the available evidence and current management strategies for individuals with inherited platelet disorders during pregnancy and delivery.

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