Cesarean delivery in a pregnant woman with glanzmann thrombasthenia: Multimodal bleeding management supported by ankaferd blood stopper

Glanzmann Thrombasthenia (GT) is a rare inherited platelet disorder caused by qualitative or quantitative defects of the GPIIb/IIIa complex, leading to impaired platelet aggregation and severe bleeding risk. Obstetric management requires a multidisciplinary and individualized approach. We report a 33-year-old primigravid woman with hereditary GT diagnosed at age 9 who underwent cesarean delivery at 37 weeks under general anesthesia after failed induction. Preoperatively, one unit of apheresis platelets was transfused. Following cord clamping, recombinant factor VIIa (rFVIIa) and tranexamic acid were administered. After placental removal, bilateral uterine artery ligation using the modified O’Leary technique was performed, and topical Ankaferd Blood Stopper (ABS) was applied to the uterus and subcutaneous tissue. A subcutaneous hematoma on postoperative day 12 was successfully managed with evacuation and local measures, including repeat topical ABS application. This case highlights that cesarean delivery can be safely accomplished in GT with multimodal hemostatic strategies, including rFVIIa, antifibrinolytics, surgical devascularization, and topical hemostatic agents.