Premium
Clinical management and outcome for mother and child in suspected cases of NAITP
Author(s) -
Husebekk A.,
Jaegtvik S.,
Killie M. K.,
Aune B.,
Oian P.,
Dahl L.B.,
Skogen B. R.
Publication year - 2000
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1046/j.1365-3148.2000.00261-16.x
Subject(s) - medicine , pregnancy , caesarean section , pediatrics , regimen , neonatal alloimmune thrombocytopenia , antibody , platelet transfusion , obstetrics , isoantibodies , platelet , fetus , surgery , immunology , genetics , biology
Severe thrombocytopenia of the newborn is most often caused by alloantibodies to platelet antigens (a‐HPA 1a). The presence of alloantibodies may be suspected in newborns with signs or symptoms of thrombocytopenia. When a‐HPA 1a is detected in a pregnant woman, there is no general agreement on follow up in pregnancy or about time and mode of delivery. The aim of the present study was to identify pregnancies at risk, follow the women with a‐HPA 1a antibodies determinations and clinical evaluations and plan the delivery as safe as possible with respect to severe bleedings. R esults The frequency of HPA 1bb was found to be 2·1% (n=17,000) and in 12·0% of the HPA 1bb women, anti‐HPA 1a antibodies were detected. Fourteen babies were born with thrombocytopenia of < 35 × 10 9 L −1 and transfused. There was a clear correlation between antibody level in the mother and the severity of thrombocytopenia in the newborns. Beside from one clinical insignificant intracranial bleeding (ICH) detected by CT, all the children were healthy. D iscussion Based on earlier publications, 5–6 babies in our material should have had ICH with neurological sequels. We believe that the combination of early detection of antibodies, close clinical follow up, termination of the pregnancy at week 38 by Caesarean section and immediate compatible platelet transfusion may explain the profitable clinical outcome for the babies. This relatively simple regimen is beneficial for improvement of perinatal morbidity and mortality.