Fetal and neonatal alloimmune thrombocytopenia: recommendations for evidence-based practice, an international approach

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

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 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.

Detaljer

Författare
  • International Collaboration for Transfusion Medicine Guidelines (ICTMG)
  • Lani Lieberman
  • Andreas Greinacher
  • Michael F. Murphy
  • James Bussel
  • Tamam Bakchoul
  • Stacy Corke
  • Mette Kjaer
  • Jens Kjeldsen-Kragh
  • Gerald Bertrand
  • Dick Oepkes
  • Jillian M. Baker
  • Heather Hume
  • Edwin Massey
  • Cécile Kaplan
  • Donald M. Arnold
  • Shoma Baidya
  • Greg Ryan
  • Helen Savoia
  • Denise Landry
  • Nadine Shehata
Enheter & grupper
Externa organisationer
  • University of Toronto
  • University Medicine Greifswald
  • University of Oxford
  • University Hospital of Tubingen
  • Finnmark Hospital Trust
  • University Hospital of North Norway
  • Regional Laboratories Region Skåne
  • French Blood Services of Brittany
  • Leiden University Medical Centre
  • Hospital for Sick Children, Toronto
  • Centre Hospitalier Universitaire Sainte-Justine
  • Institut National de la Transfusion Sanguine (INTS)
  • Canadian Blood Services
  • Australian Red Cross Blood Service
  • Mount Sinai Hospital of University of Toronto
  • Royal Children's Hospital, Melbourne
  • University Health Network University of Toronto
  • Oxford University Hospital
  • Cornell University
  • Naitbabies.org
  • St. Michael's Hospital
  • University of Montreal, Canada
  • National Health Service Blood and Transplant
  • McMaster University
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Hematologi

Nyckelord

Originalspråkengelska
Sidor (från-till)549-562
TidskriftBritish Journal of Haematology
Volym185
Utgivningsnummer3
Tidigt onlinedatum2019 mar 3
StatusPublished - 2019
PublikationskategoriForskning
Peer review utfördJa