Fetal and neonatal alloimmune thrombocytopenia

How might fetal and neonatal alloimmune thrombocytopenia (NAIT) be treated?

As there is no universal screening test for NAIT, the first case of NAIT in a family is often unexpected. However, there is a high recurrence risk for NAIT and consultation with a maternal-fetal medicine specialist or other professional with experience treating NAIT is indicated in future pregnancies once a diagnosis of NAIT is made. Blood tests performed on the mother, father, and baby can be used to decide which pregnancies/babies are at risk.

Management for pregnancies determined to be at risk remains controversial but may include a planned delivery and maternal avoidance of nonsteroidal anti- inflammatory drugs (NSAIDS) and aspirin during pregnancy. Management strategies have also included maternal intravenous immunoglobulin (IVIG) or maternal steroids and more invasive procedures such as fetal blood sampling and fetal platelet transfusions. The less invasive approach is currently favored.

Management of the affected infant after birth depends on the specific signs and symptoms but may include periodic ultrasounds of the brain to check for bleeding, platelet transfusion, and IVIG. In the absence of intracranial bleeding, the prognosis is generally favorable and the platelet count usually improves within 8 to 10 days.

Last updated on 05-01-20

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Drug Name Generic Name
Nplate romiplostim

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