Epidural anesthesia for labor and delivery in a patient with May-Hegglin anomaly: a case report

We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essen...

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Bibliographic Details
Published in:Local and regional anesthesia 2017-01, Vol.10, p.53-58
Main Authors: Muzannar, Annas Muhammad, Al Harbi, Mohammed, Rathore, Raza, Tawfeeq, Nasser, Wambi, Freddie, Mahmood, Nasir, Albrechtova, Sonia, Dimitriou, Vassilios
Format: Article
Language:English
Subjects:
Anesthesia
Biopsy
Blood platelets
Bone marrow
Care and treatment
Case Report
Case reports
Cesarean section
Childbirth & labor
Epidural anesthesia
Granulocytes
Health aspects
Hematology
Immunoglobulins
Inherited thrombocytopaenias
Leukocyte disorders
May-Hegglin anomaly
Mutation
Obstetrics
Patients
Pregnancy
Pregnant women
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Summary:We report a case of May-Hegglin anomaly (MHA) in a woman who had a successful labor and delivery under epidural anesthesia. MHA is an inherited thrombocytopenia easily misdiagnosed as idiopathic (immune) thrombocytopenic purpura (ITP). Early and appropriate diagnosis of MHA during pregnancy is essential for optimal maternal and neonatal delivery outcome. Additionally, it can avoid unnecessary diagnostic studies, such as bone marrow aspiration and biopsy, and even harmful therapies with corticosteroids, immunosuppressive agents, and splenectomy. Consequently, the most serious impacts of this disease are iatrogenic managements due to misdiagnosis. It seems that in patients with MHA, adequate clinical coagulation is far more dependent on adequate platelet function than any particular platelet count. The diagnosis of MHA may pose a challenge for clinicians managing pregnant women with thrombocytopenia.
ISSN:1178-7112
1178-7112
DOI:10.2147/LRA.S125811