Avtor/Urednik     Rožman, Primož; Telebak-Končina, Tanja
Naslov     Fetomaternal alloimmune thrombocytopenia - diagnostics, therapy and prophylaxis
Tip     članek
Vir     In: Zbornik radova sa seminara sa međunarodnim učešćem Novine u prenatalnoj i perinatalnoj zaštiti 2005 - Aloimune citopenije - profilaksa, dijagnostika i terapija; 2005 maj 27; Beograd. Beograd: Medicinski fakultet Univerziteta u Beogradu,
Leto izdaje     2005
Obseg     str. 31-8
Jezik     eng
Abstrakt     Fetomaternal alloimmune thrombocytopenia (FMAIT) is a disease of the fetus and neonate caused by anti-HPA antibodies produced by pregnant women in the course of an immune response to fetal HPA alloantigens inherited from the father. In whites, it is usually caused by the anti-HPA-1a (in 80-90% of cases), less frequently by anti-HPA-5b (in 5-15% cases) and only rarely by other antibodies. The incidence of FMAIT is around 1.5 in 1000 births and it is responsible for around 10% of all neonatal thrombocytopenias with a platelet count below 100x109/L. The fetus or neonate with FMAIT displays mucosal and skin bleeding, whereas in severe cases, intracranial haemorrhages are observed with consequent neurological damage or death. The best treatment of severe FMAIT is a transfusion of HPA-compatible platelets to the affected fetus or newborn. The use of i.v. immunoglobulins for pregnant women is less effective. If the fetus shows a serious tendency of bleeding due to thrombocytopenia, regular weekly cordocenteses with intrauterine platelet transfusions are indicated. This treatment still bears an approximate 2% mortality rate. Since the prevention of FMAIT could be easier than its therapy and since the incidence of HPA-1a alloimmunizations in whites justifies the introduction of preventive screening tests, the question of a prenatal programme for the detection of pregnancies at risk of FMAIT was raised, which would bi similar to the routine prenatal programme for prevention of haemolitic disease of the newborn due to RhD incompatibility.
Deskriptorji     THROMBOCYTOPENIA
ANTIGENS, HUMAN PLATELET
ANTIBODIES, ANTI-IDIOTYPIC
IGG
PLATELET TRANSFUSION
MATERNAL-FETAL EXCHANGE
PLATELET GLYCOPROTEIN GPIB-IX COMPLEX
PLATELET GLYCOPROTEIN GPIIB-IIIA COMPLEX