Fetal and neonatal alloimmune thrombocytopenia: from bench to bedside

Abstract

During the recent years considerable advances in the clinical and laboratory diagnosis of alloimmune thrombocytopenia have been done. Feto‐maternal alloimmunization is the commonest cause of cause of severe isolated fetal and neonatal thrombocytopenia. The condition results from maternal immunization against specific fetal platelet antigens (HPA). HPA‐1a is mostly implicated in Caucasians. The diagnosis is usually made at birth when an otherwise “well” term infant exhibits bleeding at delivery or few hours afterwards. The most feared complication of this disorder is the occurrence of intracranial hemorrhage (ICH) as a result of severe thrombocytopenia leading to death or neurological sequels. The diagnosis of alloimmune thrombocytopenia enables appropriate management of the index case and future pregnancies. Due to the recurrence and increasing severity of this condition in subsequent pregnancies with incompatible fetuses, antenatal management has been proposed. Predictive maternal parameters for severe fetal thrombocytopenia and therapy effectiveness are important for the development of non‐ invasive strategy.