Vol 86, No 1 (2015)
ARTICLES
PREVFNAIT Prevention of foetal/neonatal alloimmune thrombocytopenia (FNAIT) in Polish foetuses and newborns – the PREVFNAIT program
Małgorzata Ewa Uhrynowska, Marzena Dębska, Katarzyna Guz, Agnieszka Orzińska, Agnieszka Wróbel, Krystyna Maślanka, Romuald Dębski, Ewa Brojer
DOI: 10.17772/gp/1901
·
Ginekol Pol 2015;86(1).
Vol 86, No 1 (2015)
ARTICLES
Abstract
Fetal/Neonatal Alloimmune Thrombocytopenia (FNAIT) is caused by destruction of fetal blood platelets due to maternal antibodies. This condition, which most commonly results from incompatibility between the mother and the fetus for the Human Platelet Antigen-1a (HPA-1a), may lead to intracranial hemorrhage, damage of the central nervous system (CNS) and even death of the fetus or the newborn. It can be the cause of strokes in term newborns. FNAIT is usually attributed to the presence of anti-HPA-1a antibodies. Its incidence rate is estimated at approximately 1/1000- 2000 live births. In the absence of a screening program, it is usually diagnosed after birth of a child with symptoms of thrombocytopenia or CNS hemorrhage. Monitoring of antibody production and thrombocytopenia treatment to effectively minimize the risk of stroke are therefore launched only at the next pregnancy. Testing indications are broader to include fetal ultrasound for symptoms of stroke to the CNS, ventricular enlargement or
hydrocephalus, and obstetric failure. Diagnostic process is also recommended prior to the planned cordocentesis, in vitro fertilization and in sisters of mothers with children with FNAIT history. HPA-1a testing remains the best method for diagnosing pregnancies at risk. The detection frequency for FNAIT in Poland remains low Therefore, the Institute of Hematology and Transfusion Medicine (IHTM ) will have performed such HPA-1a antigen testing in 30000 Polish women within the framework of the PREVFNAIT program by March 2016. HPA-1a negative women (2% of the population) are a risk group for production of anti- HPA-1a antibodies responsible for FNAIT therefore all of them will be monitored for the presence and activity of anti-HPA-1a antibodies. Such testing will be performed free of charge for the women. The scientific goals related to the grant include 1) estimation of FNAIT prevalence in Poland and 2) search for biomarkers to predict the risk of the antibody production and severity of fetal thrombocytopenia.
Abstract
Fetal/Neonatal Alloimmune Thrombocytopenia (FNAIT) is caused by destruction of fetal blood platelets due to maternal antibodies. This condition, which most commonly results from incompatibility between the mother and the fetus for the Human Platelet Antigen-1a (HPA-1a), may lead to intracranial hemorrhage, damage of the central nervous system (CNS) and even death of the fetus or the newborn. It can be the cause of strokes in term newborns. FNAIT is usually attributed to the presence of anti-HPA-1a antibodies. Its incidence rate is estimated at approximately 1/1000- 2000 live births. In the absence of a screening program, it is usually diagnosed after birth of a child with symptoms of thrombocytopenia or CNS hemorrhage. Monitoring of antibody production and thrombocytopenia treatment to effectively minimize the risk of stroke are therefore launched only at the next pregnancy. Testing indications are broader to include fetal ultrasound for symptoms of stroke to the CNS, ventricular enlargement or
hydrocephalus, and obstetric failure. Diagnostic process is also recommended prior to the planned cordocentesis, in vitro fertilization and in sisters of mothers with children with FNAIT history. HPA-1a testing remains the best method for diagnosing pregnancies at risk. The detection frequency for FNAIT in Poland remains low Therefore, the Institute of Hematology and Transfusion Medicine (IHTM ) will have performed such HPA-1a antigen testing in 30000 Polish women within the framework of the PREVFNAIT program by March 2016. HPA-1a negative women (2% of the population) are a risk group for production of anti- HPA-1a antibodies responsible for FNAIT therefore all of them will be monitored for the presence and activity of anti-HPA-1a antibodies. Such testing will be performed free of charge for the women. The scientific goals related to the grant include 1) estimation of FNAIT prevalence in Poland and 2) search for biomarkers to predict the risk of the antibody production and severity of fetal thrombocytopenia.
Keywords
fetal / neonatal alloimmune thrombocytopenia / HPA-1a cohort study / anti-HPA-1a antibodies platelet transfusions / IVIG treatment /
Title
PREVFNAIT Prevention of foetal/neonatal alloimmune thrombocytopenia (FNAIT) in Polish foetuses and newborns – the PREVFNAIT program
Journal
Ginekologia Polska
Issue
Vol 86, No 1 (2015)
Page views
1000
Article views/downloads
3348
DOI
10.17772/gp/1901
Bibliographic record
Ginekol Pol 2015;86(1).
Keywords
fetal / neonatal alloimmune thrombocytopenia / HPA-1a cohort study / anti-HPA-1a antibodies platelet transfusions / IVIG treatment /
Authors
Małgorzata Ewa Uhrynowska
Marzena Dębska
Katarzyna Guz
Agnieszka Orzińska
Agnieszka Wróbel
Krystyna Maślanka
Romuald Dębski
Ewa Brojer