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Abstract

Fetal alloimmune thrombocytopenia (FAITP)

Fetal alloimmune thrombocytopenia (FAITP) is caused by maternal alloimmunization to a fetal (paternal) platelet antigen not present on maternal platelets surface.The thrombocytopenia results in maternofetal transfer of the human platelet IgG-antibodies (HPA),most frequently anti-HPA-1a into fetal circulation and removal of the antibody- binded fetal platelets by the reticulo-endothelial system (RES).

The most common presentation in those fetal and neonatal cases of severe thrombocytopenia is the presence of petechiae,haematoma (e.g. intracranial hemorrhage) or severe bleeding complications. Unfortunately the choice of antenatal therapy for FAIT is almost contentious. As less invasive measures such as maternal i.v. IgG infusions have no consistent benefit for the treatment of severe fetal alloimmune thrombocytopenia and because fetal platelet counts can be very low, careful fetal monitoring of at-risk fetuses by umbilical blood sampling from 20 to 22 weeks' gestation is indicated. Frequent platelet transfusions in short intervals (weekly) may be necessary to increase platelet counts in thrombocytopenic fetuses.

Günther Giers,Regina Riethmacher, Boris Tutschek

Reviewer:Rainer Bald, Leverkusen
und Abdulgabar Salama, Berlin

CME Praktische Fortbildung Gynäkologie, Geburtsmedizin und Gynäkologische Endokrinologie 1/2007:40- 46