Women and girls with Glanzmann’s thrombasthenia (GT) face serious bleeding risks—particularly heavy menstrual bleeding, postpartum hemorrhage and complications such as fetal and neonatal alloimmune thrombocytopenia (FNAIT)—but coordinated treatment can reduce these dangers, according to a study published recently in Haemophilia.
In this recent global registry study of 38 females with GT, 31% of newborns developed FNAIT, a condition that can cause severe bleeding in infants. These findings emphasize the urgent need for early diagnosis and a team-based approach to care.
GT is a rare inherited bleeding disorder caused by faulty platelet function. In this study, all 38 participants reported heavy menstrual bleeding, and most experienced it from their first period. A total of 82% sought emergency care for acute heavy menstrual bleeding, often requiring transfusions of blood or platelets along with hormone therapy. Nearly 70% needed complex, multi-drug regimens—including antifibrinolytics such as tranexamic acid, hormonal treatments and recombinant factor VIIa—to manage their symptoms long-term.
“[A]dvanced planning for an appropriate level of haemostatic cover for labour and delivery can reduce the risk and magnitude of PPH [postpartum hemorrhage],” explained the authors of this research. They continued, “The potential risks of alloimmunization associated with platelet transfusions might be minimised by using rFVIIa [recombinant factor VIIa] and antifibrinolytics more efficiently. However, more research is needed to further evaluate this approach.”
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Despite these interventions, bleeding risks during pregnancy and delivery remained high. Of 16 pregnancies that reached viability, 63% resulted in postpartum hemorrhage, even though most mothers had received preventive medications. When GT was diagnosed before birth, 78% still experienced significant postpartum hemorrhage, often requiring hospitalization, blood transfusions and intensive medical support.
FNAIT occurred in nearly one-third of newborns. In these cases, the mother’s immune system attacked the baby’s platelets, leading to dangerous complications like brain bleeds and extended stays in neonatal intensive care. One infant with intracranial hemorrhage needed aggressive treatment, including platelet transfusions and intravenous immunoglobulin.
Because platelet transfusions can increase the mother’s risk of developing antibodies that trigger FNAIT in future pregnancies, therapies such as recombinant factor VIIa are critical. These treatments can reduce transfusion needs while still controlling bleeding, helping protect both mother and child.
For patients with GT, especially those of childbearing age, awareness, planning and specialized care can be life-saving. This study highlights the need for clinicians to anticipate complications such as FNAIT and act quickly to manage bleeding across a woman’s reproductive lifespan.
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