Document Detail


A screening and intervention program aimed to reduce mortality and serious morbidity associated with severe neonatal alloimmune thrombocytopenia.
MedLine Citation:
PMID:  17429009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The study's objective was to identify HPA 1a-negative women and to offer them an intervention program aimed to reduce morbidity and mortality of neonatal alloimmune thrombocytopenia (NAIT). HPA 1 typing was performed in 100 448 pregnant women. The HPA 1a-negative women were screened for anti-HPA 1a. In immunized women, delivery was performed by Cesarean section 2 to 4 weeks prior to term, with platelets from HPA 1a-negative donors reserved for immediate transfusion if petechiae were present and/or if platelet count was less than 35 x 10(9)/L. Of the women screened, 2.1% were HPA 1a negative, and anti-HPA 1a was detected in 10.6% of these. One hundred seventy pregnancies were managed according to the intervention program, resulting in 161 HPA 1a-positive children. Of these, 55 had severe thrombocytopenia (< 50 x 10(9)/L), including 2 with intracranial hemorrhage (ICH). One woman with a twin pregnancy missed the follow-up and had one stillborn and one severely thrombocytopenic live child. In 15 previous prospective studies (136 814 women) there were 51 cases of severe NAIT (3 intrauterine deaths and 7 with ICH). Acknowledging the limitation of comparing with historic controls, implementation of our screening and intervention program seemed to reduce the number of cases of severe NAIT-related complications from 10 of 51 to 3 of 57.
Authors:
Jens Kjeldsen-Kragh; Mette Kjaer Killie; Geir Tomter; Elzbieta Golebiowska; Ingrid Randen; Reidun Hauge; Berit Aune; Pål Øian; Lauritz B Dahl; Jouko Pirhonen; Rolf Lindeman; Henrik Husby; Guttorm Haugen; Morten Grønn; Bjørn Skogen; Anne Husebekk
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-04-11
Journal Detail:
Title:  Blood     Volume:  110     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-23     Completed Date:  2007-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  833-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Immunity, Ullevål University Hospital, 0407 Oslo, Norway. jens.kjeldsen-kragh@medisin.uio.no
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MeSH Terms
Descriptor/Qualifier:
Adult
Antigens, Human Platelet / blood*,  immunology
Blood Grouping and Crossmatching
Blood Transfusion
Cesarean Section
Female
Fetal Death / blood,  immunology,  prevention & control
Follow-Up Studies
Humans
Immunization
Infant, Newborn
Infant, Newborn, Diseases / blood*,  immunology,  mortality,  prevention & control*
Intracranial Hemorrhages / blood,  immunology,  mortality,  prevention & control
Male
Neonatal Screening*
Platelet Count
Pregnancy
Stillbirth
Thrombocytopenia / blood*,  immunology,  mortality,  prevention & control*
Chemical
Reg. No./Substance:
0/1a alloantigen, human; 0/Antigens, Human Platelet

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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