The management of feto-maternal alloimmune thrombocytopenia: report of three cases.

Abstract

We report herein three cases of severe fetal thrombocytopenia due to anti-human platelet antigen (HPA)- 1a maternal antibodies. The first and the third cases were diagnosed on the basis of previously affected siblings and treated successfully by maternal intravenous human immunoglobulins and corticosteroids. In the second case an unexpected neonatal thrombocytopenia was found after birth without previously affected siblings and treated subsequently with intravenous immunoglobulins. Our experience supports a switch from an invasive management, including early FBS (fetal blood sampling) and platelet transfusions, to a more cautious approach. Also in severe HPA-1a alloimmunization and in 'high risk' fetuses, prenatal maternal treatment could be performed, without previous FBS, only on the basis of a risk score defined by sibling history and parents' genotypes.

• Authors: D M Paternoster, M Cester, A Memmo, R Scandellari, F Fabris, A Girolami
• Journal: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (J Matern Fetal Neonatal Med) Vol. 19 Issue 8 Pg. 517-20 (Aug 2006) ISSN: 1476-7058 [Print] England
• PMID: 16966118 (Publication Type: Case Reports, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Antigens, Human Platelet
• Immunoglobulins, Intravenous
• Immunologic Factors
• Isoantibodies

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Antigens, Human Platelet (blood, immunology)
• Cordocentesis
• Female
• Fetal Diseases (etiology)
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunologic Factors (therapeutic use)
• Infant, Newborn
• Intracranial Hemorrhages (etiology)
• Isoantibodies (immunology)
• Male
• Platelet Count
• Pregnancy
• Pregnancy Outcome
• Thrombocytopenia (complications, immunology, therapy)