From concept to practice: Screening for fetal and neonatal alloimmune thrombocytopenia (FNAIT)

IF 5.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2025-12-01 Epub Date: 2025-10-27 DOI:10.1016/j.bpobgyn.2025.102683

R. Pothof , T.W. de Vos , E. Lopriore , D. Winkelhorst , C.E. van der Schoot , M. de Haas , E.J.T. Verweij

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引用次数: 0

Abstract

Affecting 1 per 1000 to 2000 pregnancies, Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) is the leading cause for (severe) thrombocytopenia in term neonates. Due to an incompatibility between fetal and maternal platelets, maternal alloantibodies are formed against paternally derived human platelet antigens (HPAs). The alloantibodies can cross the placenta into the fetal circulation, where they can destruct the fetal platelets. As a result, severe thrombocytopenia may occur, potentially leading to intracranial hemorrhage (ICH) or severe organ bleeding during pregnancy or shortly after birth. In the absence of a universal prenatal screening program focussed on HPA-1a, FNAIT is often diagnosed too late, typically after the onset of severe fetal or neonatal bleeding complications. A screening program could be very effective in identifying the first pregnancy complicated with FNAIT, allowing timely intervention and prevent severe ICH and its associated long-term permanent sequelae. The aim of this review is to provide a comprehensive overview of the existing evidence regarding a possible future screening program for FNAIT. Additionally, challenges will be explored that need to be addressed for successful implementation of a screening program.

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从概念到实践：筛查胎儿和新生儿同种免疫性血小板减少症（FNAIT）。

胎儿和新生儿同种免疫性血小板减少症（FNAIT）影响每1000至2000例妊娠中有1例，是足月新生儿（严重）血小板减少症的主要原因。由于胎儿和母体血小板之间的不相容，母体同种抗体形成对抗父源性人血小板抗原（HPAs）。同种异体抗体可以穿过胎盘进入胎儿循环，在那里它们可以破坏胎儿的血小板。因此，严重的血小板减少可能发生，潜在地导致颅内出血（ICH）或严重的器官出血在怀孕期间或出生后不久。由于缺乏针对HPA-1a的普遍产前筛查计划，FNAIT通常被诊断得太晚，通常是在出现严重的胎儿或新生儿出血并发症之后。筛查程序可以非常有效地识别首次妊娠合并FNAIT，允许及时干预并预防严重的脑出血及其相关的长期永久性后遗症。本综述的目的是对现有证据进行全面概述，以确定未来可能的FNAIT筛查方案。此外，还将探讨为成功实施筛查计划而需要解决的挑战。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research Clinical Obstetrics & Gynaecology 医学-妇产科学

CiteScore

9.40

自引率

1.80%

发文量

113

审稿时长

54 days

期刊介绍： In practical paperback format, each 200 page topic-based issue of Best Practice & Research Clinical Obstetrics & Gynaecology will provide a comprehensive review of current clinical practice and thinking within the specialties of obstetrics and gynaecology. All chapters take the form of practical, evidence-based reviews that seek to address key clinical issues of diagnosis, treatment and patient management. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. Management will be described in practical terms so that it can be applied to the individual patient.