Short Communication

Archives of Gynecology and Obstetrics

, Volume 282, Issue 5, pp 573-575

First online:

Fetal genotyping for platelets antigens: a precise tool for alloimmune thrombocytopenia: case report and literature review

  • Marcelo Luís NomuraAffiliated withHematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária Email author 
  • , Egle CoutoAffiliated withHematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária
  • , Beatriz Moraes MartinelliAffiliated withHematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária
  • , Maria Lourdes Barjas-CastroAffiliated withHematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária
  • , Ricardo BariniAffiliated withHematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária
  • , Renato Passini JúniorAffiliated withHematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária
  • , Vagner CastroAffiliated withHematology and Hemotherapy Center, Centro de Atenção Integral à Saúde da Mulher (CAISM), Universidade Estadual de Campinas (Unicamp), Cidade Universitária

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Abstract

Introduction

Maternal–fetal alloimmune thrombocytopenia complicates about 0.1% of all pregnancies and is associated with major fetal and neonatal morbidity and mortality, especially spontaneous central nervous system bleeding leading to death and neurological handicaps. Successful prevention and treatment depend on the identification of at-risk possible carriers of anti-platelet antibodies.

Case report

We report a case of a mother with a previous child that developed neonatal hemorrhage; HPA-5b anti-platelet antibodies were detected post-natally. During the next pregnancy, fetal genotyping confirmed the presence of HPA-5b antigen; she was treated with weekly intravenous human immunoglobulin and oral prednisone. Pregnancy evolved without remarkable features and a full-term baby was delivered, with normal platelet counts.

Conclusion

Fetal alloimmune thrombocytopenia is a potentially lethal condition, but early detection and prevention lead to successful outcome in most cases.

Keywords

Thrombocytopenia, neonatal alloimmune Antigens, human platelet Pregnancy Fetal diseases Immunization, passive