Foetal and neonatal alloimmune thrombocytopenia

The use of IVIg in fetal and neonatal alloimmune thrombocytopenia— Principles and mechanisms

“…Due to the lack of a population-based screening program as it is performed in hemolytic disease of the fetus and newborn (HDFN), the red blood cell counterpart to FNAIT, diagnosis is mostly made after birth through the observation of neonatal thrombocytopenia [7] and bleeding complications [8]. This means that treatment is generally only available for women who had a previous pregnancy which was complicated by FNAIT or who have a sister who's pregnancy was affected [2]. Consequently, treatment tends to be individualized to the patient [3,9] and is best performed at a center specializing in neonatal care in FNAIT [2].…”

“…This means that treatment is generally only available for women who had a previous pregnancy which was complicated by FNAIT or who have a sister who's pregnancy was affected [2]. Consequently, treatment tends to be individualized to the patient [3,9] and is best performed at a center specializing in neonatal care in FNAIT [2]. Overall, medical intervention has been aimed at two outcomes -treating a FNAIT-affected newborn and preventing ICH in subsequent pregnancies [8].…”

“…Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a severe, but rare disorder that affects about 1 in 1000 newborns [1]. It is characterized by the destruction of fetal platelets by maternal antibodies directed against paternally inherited platelet antigens [2]. The major causative antigen in Caucasians is the human platelet antigen 1a (HPA-1a), but more than 30 additional implicated antigens including HPA-5b, HPA-15, HPA-3a and HPA-2a or 2b have been identified so far [2,3].…”

“…It is characterized by the destruction of fetal platelets by maternal antibodies directed against paternally inherited platelet antigens [2]. The major causative antigen in Caucasians is the human platelet antigen 1a (HPA-1a), but more than 30 additional implicated antigens including HPA-5b, HPA-15, HPA-3a and HPA-2a or 2b have been identified so far [2,3]. The most feared complication is intracranial hemorrhage (ICH) as it carries significant morbidity and mortality and usually occurs during the late stages of pregnancy [1,4].…”

Antikörper gegen Erythrozyten und Thrombozyten in der Schwangerschaft und deren perinatales Management

“…Der Schweregrad der kindlichen Alloimmunthrombozytopenie erhöht sich häufig in Folgeschwangerschaften. Das Wiederholungsrisiko beträgt 50 oder 100 %, je nach Homo-oder Heterozygotie des Vaters [29].…”