The incidence and outcomes of fetomaternal alloimmune thrombocytopenia: a UK national study using three data sources.
نویسندگان
چکیده
Fetomaternal alloimmune thrombocytopenia (FMAIT) is the most common cause of severe neonatal thrombocytopenia in otherwise well, term infants. First pregnancies are often severely affected. This descriptive, population-based national study was undertaken in order to inform the case for antenatal screening. Cases were identified using three sources and capture-recapture techniques used to generate a robust incidence estimate. One hundred and seventy three cases were identified between October 2006 and September 2008. An extra 20 cases were estimated from capture-recapture analysis, giving an estimated incidence of clinically detected FMAIT of 12·4 cases per 100 000 total births (95%confidence interval: 10·7, 14·3). Fifty-two cases (30%) were known at the start of pregnancy; 120 (70%) were unknown (n=115) or unrecognized (n=5). Unknown cases were more likely to experience a haemorrhagic complication (67% vs. 5%) (P<0·001) and more likely to have an intracranial haemorrhage (20% vs. 4%) (P=0·014) than known cases receiving antenatal management. In view of the incidence of severe disease identified, further assessment of the case for antenatal screening is important. There were a number of cases in which the significance of a history of FMAIT in a previous sibling was not recognized and there is a need to raise awareness of the importance of this diagnosis.
منابع مشابه
Neonatal alloimmune thrombocytopenia: a case study.
Neonatal alloimmune thrombocytopenia (NAIT) is a life-threatening disorder caused by fetomaternal platelet incompatibility analogous to that seen in rhesus (Rh) disease. In NAIT , maternal immunoglobulin G (IgG) antiplatelet antibodies cross the placenta, resulting in rapid destruction and removal of fetal platelets by the reticuloendothelial system. Studies have shown that NAIT has an incidenc...
متن کاملContemporary management of neonatal alloimmune thrombocytopenia: good outcomes in the intravenous immunoglobulin era: results from the Australian neonatal alloimmune thrombocytopenia registry.
OBJECTIVE To describe the natural history, antenatal and postnatal therapy, and clinical outcomes of Australian patients with fetomaternal/neonatal alloimmune thrombocytopenia (NAIT) recorded in the Australian NAIT registry. METHODS Analysis of registry data of Australian mothers treated antenatally for NAIT and any fetus/newborn with thrombocytopenia (TCP) and maternal human platelet antigen...
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We report two patients where the finding of isolated fetal hydrocephalus led to the detection of severe fetal thrombocytopenia, using fetal blood sampling. Serological investigation led to the diagnosis of fetomaternal alloimmune thrombocytopenia (FMAIT) due to anti-HPA-1a. Both women had had previous unsuccessful pregnancies probably due to FMAIT; one had had four miscarriages at 17-18 weeks' ...
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ورودعنوان ژورنال:
- British journal of haematology
دوره 152 4 شماره
صفحات -
تاریخ انتشار 2011