Document Detail


Noninvasive antenatal management of fetal and neonatal alloimmune thrombocytopenia: safe and effective.
MedLine Citation:
PMID:  17309545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To describe the outcome of pregnancies with fetal and neonatal alloimmune thrombocytopenia (FNAIT) in relation to the invasiveness of the management protocol. DESIGN: Retrospective analysis of prospectively collected data from a national cohort. SETTING: Leiden University Medical Centre, the national centre for management of severe red cell and platelet alloimmunisation in pregnancy. POPULATION: Ninety-eight pregnancies in 85 women with FNAIT having a previous child with thrombocytopenia with (n= 16) or without (n= 82) an intracranial haemorrhage (ICH). METHODS: Our management protocol evolved over time from (1) serial fetal blood samplings (FBS) and platelet transfusion (n= 13) via (2) combined FBS with maternal intravenous immunoglobulins (n= 33) to (3) completely noninvasive treatment with immunoglobulins only (n= 52 pregnancies, resulting in 53 neonates). Perinatal outcome was assessed according to the three types of management. MAIN OUTCOME MEASURES: Occurrence of ICH, perinatal survival, gestational age at birth and complications of FBS. RESULTS: All but one of 98 pregnancies ended in a live birth; none of the neonates had an ICH. The median gestational age at birth was 37 weeks (range 32-40). In groups 1 and 2, three emergency caesarean sections were performed after complicated FBS, resulting in two healthy babies and one neonatal death. CONCLUSION: Noninvasive antenatal management of pregnancies complicated by FNAIT appears to be both effective and safe.
Authors:
E S A van den Akker; D Oepkes; E Lopriore; A Brand; H H H Kanhai
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Publication Detail:
Type:  Journal Article     Date:  2007-02-19
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  114     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-23     Completed Date:  2007-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  469-73     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Lieden University Medical Centre, Leiden, The Netherlands. e.s.a.van_den_akker@lumc.nl
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MeSH Terms
Descriptor/Qualifier:
Antibodies / blood
Antigens, Human Platelet / immunology
Female
Fetal Diseases / therapy*
Gestational Age
Humans
Infant, Newborn
Platelet Transfusion
Pregnancy
Pregnancy Outcome
Prenatal Care / methods*
Prospective Studies
Retrospective Studies
Thrombocytopenia / embryology,  therapy*
Chemical
Reg. No./Substance:
0/1a alloantigen, human; 0/Antibodies; 0/Antigens, Human Platelet

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