Subamniotic Hemorrhage, a Possible New Presentation of Fetal and Neonatal Alloimmune Thrombocytopenia

Fetal Diagn Ther. 2022;49(1-2):60-64. doi: 10.1159/000521866. Epub 2022 Jan 12.

Abstract

Background: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare fetal disease in which maternal antibodies directed toward fetal human platelet antigens (HPA) are formed during pregnancy and cause fetal thrombocytopenia. The diagnosis FNAIT is suspected when a fetus or neonate presents with signs of bleeding.

Case: We describe a pregnancy complicated by a placental hematoma in the 20th week of gestation as the first manifestation of FNAIT. Further evaluation showed signs of germinal matrix hemorrhage and HPA-5b allo-antibodies. After the diagnosis, intravenous immunoglobulin was administered weekly and a healthy daughter was born at 37 weeks. Histopathological analysis revealed that the hematoma was caused by a subamniotic hemorrhage of fetal origin.

Conclusion: A subamniotic hematoma appears to be the first manifestation of FNAIT.

Keywords: Allo-antibodies; Fetal and neonatal alloimmune thrombocytopenia; Hematoma; Human platelet antigens-5b; Placenta; Subamniotic.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Fetus
  • Hemorrhage / complications
  • Humans
  • Infant, Newborn
  • Placenta
  • Pregnancy
  • Prenatal Care
  • Thrombocytopenia, Neonatal Alloimmune* / etiology