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Cole, Stephen

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Pathology - Journal of the RCPA: 2010 - Volume 42 - Issue - p S39
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Neonatal alloimmune thrombocytopenia (NAIT) affects approximately 1 in 1000 pregnancies. There are no effective screening or prevention strategies, and most new cases are only identified following delivery of an affected infant. The consequences of NAIT can vary from mild thrombocytopenia to severe brain injury and even fetal death. Unlike red blood cell isoimmunisation, NAIT can occur in first pregnancies. Antiplatelet antibody assays are not capable of predicting risk of adverse outcomes, or need for intervention.

Treatment for NAIT has been controversial, with opinion divided between therapies based on invasive assessment of fetal platelets coupled with platelet transfusion, and therapies based on maternal treatment with intravenous immunoglobulin (IVIG) and corticosteroids. Several recent studies have shown that maternal IVIG treatment and avoidance of fetal invasive procedures can be safe and effective, avoiding the serious consequences of fetal interventions. Despite these advances, NAIT remains a poorly understood condition, which continues to pose numerous challenges.

© 2010 Royal College of Pathologists of Australasia