[Thirty years of platelet immunology in fetal and neonatal alloimmune thrombocytopenia management, current situation]

Abstract

Fetal and neonatal allo-immune thrombocytopenia (FNAIT) is considered as a rare disease due to the incidence (1/1000-1/2000 births). The major complication of severe thrombocytopenia is bleeding and particularly intra-cranial hemorrhage and neurologic sequelae following. Serology and molecular biology developments have reconfigured the platelet immunology diagnosis. Anti-HPA-1a allo-immunisation is responsible for more than 80% FNAIT cases with a high recurrence rate of severe bleeding complications. Therapeutic management has changed over the coming years from an invasive concept associating fetal blood sampling and in utero platelet transfusion to a non invasive treatment by intravenous immunoglobulins injection (IVIg). The purpose of this article is to provide an update on FNAIT management in the light of current developments over the past 30years.

Keywords: Allo-immunisation plaquettaire; Diagnostic prénatal; Fetal and neonatal thrombocytopenia; Grossesse; Platelet alloimmunisation; Platelet transfusion; Pregnancy; Prenatal diagnosis; Thrombopénies fœtales et néonatales allo-immunes; Transfusion plaquettaire.