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E u r o S c i C o n C o n f e r e n c e o n
PEDIATRICS
2017
Pediatrics 2017
Volume:3 Issue:4(Suppl)
Journal of Pediatric Care
ISSN 2471-805X
N o v e m b e r 1 3 - 1 4 , 2 0 1 7
L o n d o n , U K
Page 43
L
eading cause of moderate or severe thrombocytopenia
is immune thrombocytopenia in otherwise healthy
appearing neonates. Immune thrombocytopenia in the
fetus or newborn may result from platelet alloantibodies
against paternal antigens inherited by the fetus (alloimmune
thrombocytopenia) or platelet autoantibodies in the mother
with immune thrombocytopenic purpura (ITP). Only 10% of
human platelet antigen (HPA)-1a negative mothers who are
exposed to HPA-1a positive fetal platelets during pregnancy
develop HPA-1a alloantibodies, and 30% of fetuses/neonates
will develop thrombocytopenia and 20% of these cases being
severe.Most serious complicationof severe fetal andneonatal
alloimmune thrombocytopenia (FNAIT) is intracranial
hemorrhage (ICH) which has been detected in 10-20 percent
of affected fetuses/neonates, with most cases occuring
antenatally, and leads neurological sequale in 20%, and
deaths 5-10%. There is no evidence-based optimal treatment
strategy. Platelet antibody titration in maternal plasma is not
helpful for decision making. The best indicator for current
pregnancy is the outcome of the previous pregnancy. The
risk of recurrence among subsequent HPA-positive sibling is
close to 100% where the previous sibling was affected with
antenatal intracranial ICH. The risk of ICH becomes high with
more severe and earlier onset in each subsequent pregnancy.
Newborns born to
mothers with immune
trombocytopenic
purpura
Murat Yurdakök
Hacettepe University Faculty of Medicine,
Turkey
J Pediatr Care 2017, 3:4(Suppl)
DOI: 10.21767/2471-805X-C1-003
Serial platelet counts shoud be obtained for the first 5-7 days
of delivery to keep the platelet counts higher than 30,000/µL
without active bleeding and higher that 50,000-100,000/uL with
active bleeding. IVIG is not alternative to platalet transfusions,
since platelet counts are not rise before 24-48 h. In platelet
transfused patients, IVIG can be given to potentially prolong
the survival of the incompatible platelet. ITP during pregnancy
is not considered a serious risk of perinatal bleeding, but may
cause a moderate thrombocytopenia in neonate. In mothers
with ITP, the risk of thrombocytopenia is only 10%, with no more
than 1% risk of in utero ICH
muratyurdakok@yahoo.com