Fetal alloimmune thrombocytopenia in pregnant woman with anti-HPA-1a antibodies

Czech version

Authors: K. Sobíšková; J. Matěcha
Authors‘ workplace: Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha, zastupující přednosta MUDr. R. Chmel, Ph. D., MHA
Published in: Ceska Gynekol 2016; 81(4): 300-303

Overview

Object:
Description of the pregnancy in patient with anti-HPA-1a antibodies.

Design:
Case report.

Setting:
Department of Obstetrics and Gynaecology, 2^nd Faculty of Medicine, Charles University in Prague and Motol University Hospital.

Case report:
Report of cases of neonatal alloimune thrombocytopenia in a patient with proven anti-HPA 1a antibodies. The immunization developed during the first pregnancy, accompanied with fetal thrombocytopenia which recurred in every subsequent pregnancy with greater severity. None of the neonates was affected by intracranial hemorrhage.

Keywords:
alloimmune thrombocytopenia, pregnancy, neonatal intracranial hemorrhage

Sources

1. van den Akker, E., Oepkes, D., Brand, A., Kanhai, HH. Vaginal delivery for fetuses at risk of alloimmune thrombocytopenia? BJOG, 2006, 113(7), p. 781–783.

2. Baer, VL., Lambert, DK., Henry, E., Christensen, RD. Severe thrombocytopenia in the NICU. Pediatrics, 2009, 124(6), p. 1095–1100.

3. Berkowitz, RL., Bussel, JB., McFarland, JG. Alloimmune thrombocytopenia: state of the art 2006. Am J Obstet Gynecol, 2006, 195(4), p. 907–913.

4. Bussel, JB., Berkowitz, RL., Hung, C., et al. Intracranial hemorrhage in alloimmune thrombocytopenia: stratified management to prevent recurrence in the subsequent affected fetus. Am J Obstet Gynecol, 2010, 203(2), p. 135.

5. Bussel, JB., Berkowitz, RL., Lynch, L., et al. Antenatal management of alloimmune thrombocytopenia with intravenous gamma-globulin: a randomized trial of the addition of low-dose steroid to intravenous gamma-globulin. Am J Obstet Gynecol, 1996, 174(5), p. 1414–1423.

6. Bussel, JB., Zabusky, MR., Berkowitz, RL., McFarland, JG. Fetal alloimmune thrombocytopenia. N Engl J Med, 1997, 337(1), p. 22–26.

7. Davoren, A., Curtis, BR., Aster, RH., McFarland, JG. Human platelet antigen-specific alloantibodies implicated in 1162 cases of neonatal alloimmune thrombocytopenia. Transfusion, 2004, 44(8), p. 1220–1225.

8. Herman, JH., Jumbelic, MI., Ancona, RJ., Kickler, TS. In utero cerebral hemorrhage in alloimmune thrombocytopenia. Am J Pediatr Hematol Oncol, 1986, 8(4), p. 312–317.

9. Delbos, F., Bertrand, G., Croisille, L., et al. Fetal and neonatal alloimmune thrombocytopenia: predictive factors of intracranial hemorrhage. Transfusion, 2016, 56(1), p. 59–66.

10. Chakravorty, S., Roberts, I. How I manage neonatal thrombocytopenia. Br J Haematol, 2012, 156(2), p. 155–162.

11. Kamphuis, MM., Paridaans, N., Porcelijn, L., et al. Screening in pregnancy for fetal or neonatal alloimmune thrombocytopenia: systematic review. BJOG, 2010, 117(11), p. 1335–1343.

12. Lipitz, S., Ryan, G., Murphy, MF., Robson, SC., et al. Neonatal alloimmune thrombocytopenia due to anti-P1A1 (anti-HPA-1a): importance of paternal and fetal platelet typing for assessment of fetal risk. Prenat Diagn, 1992, 12(11), p. 955–958.

13. McFarland, JG., Aster, RH., Bussel, JB., et al. Prenatal diagnosis of neonatal alloimmune thrombocytopenia using allele-specific oligonucleotide probes. Blood, 1991,78(9), p. 2276–2282.

14. Overton, TG., Duncan, KR., Jolly, M., et al. Serial aggressive platelet transfusion for fetal alloimmune thrombocytopenia: platelet dynamics and perinatal outcome. Am J Obstet Gynecol, 2002, 186(4), p. 826–831.

15. Paidas, MJ., Berkowitz, RL., Lynch, L., et al. Alloimmune thrombocytopenia: fetal and neonatal losses related to cordocentesis. Am J Obstet Gynecol, 1995, 172, p. 475–479.

16. Pacheco, LD., Berkowitz, RL., Moise, KJ. Jr., et al. Fetal and neonatal alloimmune thrombocytopenia: a management algorithm based on risk stratification. Obstet Gynecol, 2011, 118(5), p. 1157–1163.

17. Peterson, JA., McFarland, JG., Curtis, BR., Aster, RH. Neonatal alloimmune thrombocytopenia: pathogenesis, diagnosis and management. Br J Haematol, 2013, 161(1), p. 3–14.

18. Radder, CM., Brand, A., Kanhai, HH. Will it ever be possible to balance the risk of intracranial haemorrhage in fetal or neonatal alloimmune thrombocytopenia against the risk of treatment strategies to prevent it? Vox Sang, 2003, 84(4), p. 318–325.

19. Sainio, S., Teramo, K., Kekomäki, R. Prenatal treatment of severe fetomaternal alloimmune thrombocytopenia. Transfus Med, 1999, 9(4), p. 321–330.