Management of alloimmune thrombocytopenia: antenatal diagnosis and in utero transfusion of maternal platelets.

Abstract:

:Neonatal alloimmune thrombocytopenia (NAIT) can cause severe bleeding in the central nervous system (CNS) and death or severe neurologic sequelae. The expression of the PLA1 antigen is detectable as early as 19 weeks of gestation. Alloimmunization can therefore lead to fetal thrombocytopenia very early in pregnancy. Until recently, we have had no means of detecting and assessing the severity of fetal thrombocytopenia during pregnancy. The level of the maternal antibody is not of a predictable value since 20% of the mothers had no circulating antibodies in our series. An alternative approach is to carry out investigations on fetal blood samplings. This management leads to an exact knowledge of the fetal status and antenatal diagnosis is feasible as early as the 21st week of gestation. Early diagnosis facilitates appropriate management and makes possible such therapeutic options as in utero maternal platelet transfusions. We report our experience in the antenatal diagnosis and management of nine cases with in utero transfusion in the six cases with severe thrombocytopenia. All neonates did well, with no signs of bleeding at birth. No side effects of therapy were noted after a period ranging from 6 months to 3 years.

journal_name

Blood

journal_title

Blood

authors

Kaplan C,Daffos F,Forestier F,Cox WL,Lyon-Caen D,Dupuy-Montbrun MC,Salmon C

subject

Has Abstract

pub_date

1988-07-01 00:00:00

pages

340-3

issue

1

eissn

0006-4971

issn

1528-0020

journal_volume

72

pub_type

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