Centre for Reproductive Medicine and Surgery, St Bartholomew's Hospital, London, UK
Haemophilia and Thrombosis Centre, Belfast City Hospital Health and Social Services Trust, Belfast, UK.
BMJ Case Rep. 2022 Aug 31;15(8):e250405. doi: 10.1136/bcr-2022-250405.
Bernard-Soulier syndrome (BSS) is a rare congenital bleeding disorder of the platelet, and it is mainly inherited as an autosomal recessive trait. It is caused by both qualitative and quantitative deficiency of the platelet membrane glycoprotein (GP) Ib-IX-V receptor complex, thereby causing abnormal platelets adhesion.We report a case of a primigravida in her 20s with history of BSS diagnosed in childhood due to family history. Her preconception period was challenging as she suffered from severe menorrhagia often requiring hospital admission, blood and platelet transfusions.At 35 weeks gestation, she developed temporal crowded retinal detachment of the left eye and had a successful left scleral buckling surgery under general anaesthesia (GA).She had a multidisciplinary team care with a successful elective GA caesarean section at 39+3 weeks gestation with peridelivery platelet transfusion and intravenous recombinant factor VIIa. Regional anaesthesia, intramuscular injections and anticoagulation were avoided.
伯纳德-苏利耶综合征(BSS)是一种罕见的血小板先天性出血性疾病,主要遗传方式为常染色体隐性遗传。其病因是血小板膜糖蛋白(GP)Ib-IX-V 受体复合物的质和量均有缺陷,导致血小板黏附异常。我们报告了一例 20 多岁的初产妇,她因家族史在儿童时期被诊断为 BSS。她的孕前阶段充满挑战,经常因严重月经过多而需要住院,接受输血和血小板输注。在 35 周妊娠时,她左眼发生短暂性视网膜脱离,在全身麻醉(GA)下成功进行了左眼巩膜扣带术。她接受了多学科团队的治疗,在 39+3 周妊娠时成功进行了选择性 GA 剖宫产术,分娩期间输注血小板和静脉内重组因子 VIIa。避免了区域麻醉、肌肉注射和抗凝治疗。