Contemporary management of neonatal alloimmune thrombocytopenia: good outcomes in the intravenous immunoglobulin era: results from the Australian neonatal alloimmune thrombocytopenia registry

被引：11

作者：

Crighton, Gemma L. ^{[1
,2
,3
]}

Scarborough, Ri ^{[1
]}

McQuilten, Zoe K. ^{[1
,4
]}

Phillips, Louise E. ^{[1
]}

Savoia, Helen F. ^{[3
,5
]}

Williams, Bronwyn ^{[6
,7
]}

Holdsworth, Rhonda ^{[2
]}

Henry, Amanda ^{[8
,9
]}

Wood, Erica M. ^{[1
,10
]}

Cole, Stephen A. ^{[5
]}

机构：

[1] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia

[2] Australian Red Cross Blood Serv, Melbourne, Vic, Australia

[3] Royal Childrens Hosp, Melbourne, Vic, Australia

[4] Australia & New Zealand Intens Care Res Ctr, Melbourne, Vic, Australia

[5] Royal Womens Hosp, Melbourne, Vic, Australia

[6] Royal Brisbane & Womens Hosp, Brisbane, Qld, Australia

[7] Lady Cilento Childrens Hosp, Brisbane, Qld, Australia

[8] Univ New South Wales, Sch Womens & Childrens Hlth, Sydney, NSW, Australia

[9] St George Hosp, Sydney, NSW, Australia

[10] Monash Med Ctr, Melbourne, Vic, Australia

来源：

JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE | 2017年 / 30卷 / 20期

基金：

英国医学研究理事会;

关键词：

Fetomaternal; neonatal alloimmune thrombocytopenia; human platelet antigen; intracranial haemorrhage; neonatal thrombocytopenia; intravenous immunoglobulin; FETAL; HEMORRHAGE;

D O I：

10.1080/14767058.2016.1253064

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: To describe the natural history, antenatal and postnatal therapy, and clinical outcomes of Australian patients with fetomaternal/neonatal alloimmune thrombocytopenia (NAIT) recorded in the Australian NAIT registry.Methods: Analysis of registry data of Australian mothers treated antenatally for NAIT and any fetus/newborn with thrombocytopenia (TCP) and maternal human platelet antigen (HPA) antibodies.Results: Ninety four potential cases (91 pregnancies; three twin pregnancies) were registered between December 2004 and September 2015 with 76 confirmed or treated as NAIT. NAIT was frequently unanticipated (44 cases, 58%), whilst 32 cases (42%) were anticipated due to personal or family history. In 70/76 cases, the diagnosis of NAIT was made based on HPA antibody results; anti-HPA-1a was most commonly detected (58/70, 82%), followed by anti-HPA-5b (5/70, 7%). Intracranial haemorrhage (ICH) was detected in seven cases (9%). Maternal antenatal therapy resulted in improved clinical outcomes. For antenatally treated cases, whilst 10/29 (34%) neonates had severe TCP, only one ICH was detected.Conclusions: This study provides data on contemporary real world management of Australian mothers and babies with NAIT. Antenatal IVIG therapy was associated with better neonatal outcomes. Maternal side-effects and treatment costs were substantial.

引用

页码：2488 / 2494

页数：7

共 25 条

[1] The Development of Severe Neonatal Alloimmune Thrombocytopenia due to Anti-HPA-1a Antibodies Is Correlated to Maternal ABO Genotypes [J].