| Noninvasive antenatal management of fetal and neonatal alloimmune thrombocytopenia: safe and effective. | |
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MedLine Citation:
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PMID: 17309545 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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E S A van den Akker; D Oepkes; E Lopriore; A Brand; H H H Kanhai |
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Publication Detail:
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Type: Journal Article Date: 2007-02-19 |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 114 ISSN: 1470-0328 ISO Abbreviation: BJOG Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-03-23 Completed Date: 2007-05-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 469-73 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics, Lieden University Medical Centre, Leiden, The Netherlands. e.s.a.van_den_akker@lumc.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies
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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:
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0/1a alloantigen, human; 0/Antibodies; 0/Antigens, Human Platelet |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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