+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Management and outcome of 200 cases of fetomaternal alloimmune thrombocytopenia

, : Management and outcome of 200 cases of fetomaternal alloimmune thrombocytopenia. Transfusion 47(5): 901-910

BACKGROUND: Fetomaternal alloimmune thrombocytopenia (FMAIT) is the commonest cause of severe thrombocytopenia in term neonates but its management remains controversial.STUDY DESIGN AND METHODS: A 7-year prospective observational study of 200 cases of FMAIT evaluated the relationship between human platelet antigen (HPA) antibody specificity, clinical presentation, morbidity, mortality, and therapeutic interventions in the antenatal and postnatal period, with long-term follow-up of neonates with intracranial hemorrhage (ICH).RESULTS: In 1148 referrals for FMAIT, HPA antibodies were confirmed in 200 (17%). The commonest specificities were anti-HPA-1a, 150 (75%); anti-HPA-5b, 31 (15.5%); and anti-HPA-15b, 8 (4%). Of 123 (62%) cases (two sets of twins) with no previous history of FMAIT, intrauterine deaths occurred in 5: anti-HPA-1a alone, 3; in combination with anti-HPA-5b, 1; and anti-HPA-15b, 1. Of the 120 live neonates, 103 had severe thrombocytopenia and 17 (14%) developed ICH (anti-HPA-1a, 13; anti-HPA-5b, 3; anti-HPA-15b, 1). Postnatal care varied widely with 37 percent of neonates receiving random rather than HPA-1a and -5b-negative platelets. Of the remaining 77 cases with a history of FMAIT, 40 received intrauterine transfusions. Six (15%) of these fetuses died in utero and an additional 2 developed ICH postnatally. Of the 19 children with ICH, 1 (anti-HPA-15b) died on Day +1, and neurologic sequelae persist in 13 (mean follow-up, 2.5 years).CONCLUSION: HPA-1a antibodies are most commonly implicated in severe thrombocytopenia but HPA-5b and HPA-15b antibodies can also result in poor outcome. Postnatal transfusion management is extremely variable, and fetal transfusions are associated with significant morbidity and mortality.


PMID: 17465957

DOI: 10.1111/j.1537-2995.2007.01208.x

Other references

Wolbert J.; Rogers P.; Keyes C.; Marte C.; Smothers K., 1989: A comparison of health care delivered to people with aids and arc by a nurse practitioner and a physician a case matched retrospective study. Morisset, R A (Ed ) Ve Conference Internationale Sur Le Sida: Le Defi Scientifique Et Social; V International Conference on Aids: The Scientific And Social Challenge; Montreal, Quebec, Canada, June 4-9, 1262p International Development Research Centre: Ottawa, Ontario, Canada Illus Paper 275

Meissner, W.W., 1980: A note on projective identification. Journal of the American Psychoanalytic Association 28(1): 43-67

Zee, C.S.; Segall, H.D.; Terk, M.R.; Destian, S.; Ahmadi, J.; Gober, J.R.; Colletti, P.M., 1992: SPIR MRI in spinal diseases. We report on our experience with the fat suppression technique of spectral presaturation with inversion recovery MR in imaging certain spinal disorders. This technique may assist in demonstrating or excluding the presence of fat within a lesion (s...

Osaka, T.; Hashimoto, Y.; Fukuda, T.; Tanaka, M.; Yamazaki, M.; Fukui, M., 2016: Relationship between skeletal muscle mass and hepatic fibrosis in patients with type 2 diabetes. Diabetes & Metabolism: -

Payne, B.O., 2014: XVII. Observations on microscope condensers, objectives, and eyepieces. II. Microscope objectives. Journal. Royal Microscopical Society 70(4): 317-341

Corman, M.L.; Swinton, N.W.; O'Keefe, D.D.; Veidenheimer, M.C., 1973: Colorectal carcinoma at the Lahey Clinic, 1962-1966. American Journal of Surgery 125(4): 424-428

Schroeder J.O.; Heer A.H.; Euler H.H.; Loeffler H., 1991: High dose immunoglobulins in systemic lupus erythematosus sle. Immunobiology 183(3-4): 209

Osborne, J., 1997: Student nurses on the Internt. NlmCategory="UNASSIGNED">The words 'nurse' and 'Internet' seem strange in the same sentence. The response I get when I mention the Internet as a tool for networking is nearly always one of surprise. I've often...

Darveau, R.P.; Cunningham, M.D.; Seachord, C.L.; Cassiano-Clough, L.; Cosand, W.L.; Blake, J.; Watkins, C.S., 1991: Beta-lactam antibiotics potentiate magainin 2 antimicrobial activity in vitro and in vivo. The ability of magainin 2 to augment antibiotic therapy was examined. Susceptibility to magainin 2 was determined on Escherichia coli incubated in the presence and absence of sublethal concentrations of antibiotics both in vitro and in vivo. Exper...

Fassati, M., 1944: De generis Bern-bidion (subg. Peryphus Steph.) formis geographicis novis. Sbornik Entomologickeho Oddeleni zemsk Musea Praze, 21-22(1943-44): 294-299