Fetal and neonatal alloimmune thrombocytopenia : recommendations for evidence-based practice, an international approach
(2019) In British Journal of Haematology 185(3). p.549-562- Abstract
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may result in severe bleeding, particularly fetal and neonatal intracranial haemorrhage (ICH). As a result, FNAIT requires prompt identification and treatment; subsequent pregnancies need close surveillance and management. An international panel convened to develop evidence-based recommendations for diagnosis and management of FNAIT. A rigorous approach was used to search, review and develop recommendations from published data for: antenatal management, postnatal management, diagnostic testing and universal screening. To confirm FNAIT, fetal human platelet antigen (HPA) typing, using non-invasive methods if quality-assured, should be performed during pregnancy when the father is... (More)
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may result in severe bleeding, particularly fetal and neonatal intracranial haemorrhage (ICH). As a result, FNAIT requires prompt identification and treatment; subsequent pregnancies need close surveillance and management. An international panel convened to develop evidence-based recommendations for diagnosis and management of FNAIT. A rigorous approach was used to search, review and develop recommendations from published data for: antenatal management, postnatal management, diagnostic testing and universal screening. To confirm FNAIT, fetal human platelet antigen (HPA) typing, using non-invasive methods if quality-assured, should be performed during pregnancy when the father is unknown, unavailable for testing or heterozygous for the implicated antigen. Women with a previous child with an ICH related to FNAIT should be offered intravenous immunoglobulin (IVIG) infusions during subsequent affected pregnancies as early as 12 weeks gestation. Ideally, HPA-selected platelets should be available at delivery for potentially affected infants and used to increase the neonatal platelet count as needed. If HPA-selected platelets are not immediately available, unselected platelets should be transfused. FNAIT studies that optimize antenatal and postnatal management, develop risk stratification algorithms to guide management and standardize laboratory testing to identify high risk pregnancies are needed.
(Less)
- author
- author collaboration
- publishing date
- 2019-03-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- fetal, Guideline, haematology, HPA-1a
- in
- British Journal of Haematology
- volume
- 185
- issue
- 3
- pages
- 549 - 562
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85062365171
- pmid:30828796
- ISSN
- 0007-1048
- DOI
- 10.1111/bjh.15813
- language
- English
- LU publication?
- no
- id
- 0bd060a4-986d-4f20-80f7-aeaeb97afbec
- date added to LUP
- 2019-03-15 07:46:50
- date last changed
- 2024-04-16 02:06:06
@article{0bd060a4-986d-4f20-80f7-aeaeb97afbec,
abstract = {{<p>Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may result in severe bleeding, particularly fetal and neonatal intracranial haemorrhage (ICH). As a result, FNAIT requires prompt identification and treatment; subsequent pregnancies need close surveillance and management. An international panel convened to develop evidence-based recommendations for diagnosis and management of FNAIT. A rigorous approach was used to search, review and develop recommendations from published data for: antenatal management, postnatal management, diagnostic testing and universal screening. To confirm FNAIT, fetal human platelet antigen (HPA) typing, using non-invasive methods if quality-assured, should be performed during pregnancy when the father is unknown, unavailable for testing or heterozygous for the implicated antigen. Women with a previous child with an ICH related to FNAIT should be offered intravenous immunoglobulin (IVIG) infusions during subsequent affected pregnancies as early as 12 weeks gestation. Ideally, HPA-selected platelets should be available at delivery for potentially affected infants and used to increase the neonatal platelet count as needed. If HPA-selected platelets are not immediately available, unselected platelets should be transfused. FNAIT studies that optimize antenatal and postnatal management, develop risk stratification algorithms to guide management and standardize laboratory testing to identify high risk pregnancies are needed.</p>}},
author = {{Lieberman, Lani and Greinacher, Andreas and Murphy, Michael F. and Bussel, James and Bakchoul, Tamam and Corke, Stacy and Kjaer, Mette and Kjeldsen-Kragh, Jens and Bertrand, Gerald and Oepkes, Dick and Baker, Jillian M. and Hume, Heather and Massey, Edwin and Kaplan, Cécile and Arnold, Donald M. and Baidya, Shoma and Ryan, Greg and Savoia, Helen and Landry, Denise and Shehata, Nadine}},
issn = {{0007-1048}},
keywords = {{fetal; Guideline; haematology; HPA-1a}},
language = {{eng}},
month = {{03}},
number = {{3}},
pages = {{549--562}},
publisher = {{Wiley-Blackwell}},
series = {{British Journal of Haematology}},
title = {{Fetal and neonatal alloimmune thrombocytopenia : recommendations for evidence-based practice, an international approach}},
url = {{http://dx.doi.org/10.1111/bjh.15813}},
doi = {{10.1111/bjh.15813}},
volume = {{185}},
year = {{2019}},
}