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Postnatal intervention for the treatment of FNAIT: a systematic review
- Source :
- Journal of Perinatology, 39(10), 1329-1339. NATURE PUBLISHING GROUP
- Publication Year :
- 2019
- Publisher :
- NATURE PUBLISHING GROUP, 2019.
-
Abstract
- Objective: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is associated with life-threatening bleeding. This systematic review of postnatal management of FNAIT examined transfusion of human platelet antigen (HPA) selected or unselected platelets, and/or IVIg on platelet increments, hemorrhage and mortality. Study design: MEDLINE, EMBASE and Cochrane searches were conducted until 11 May 2018. Result: Of 754 neonates, 382 received platelet transfusions (51%). HPA-selected platelets resulted in higher platelet increments and longer response times than HPA-unselected platelets. However, unselected platelets generally led to sufficient platelet increments to 30 × 10 9 /L, a level above which intracranial hemorrhage or other life-threatening bleeding rarely occurred. Platelet increments were not improved with the addition of IVIg to platelet transfusion. Conclusion: Overall, HPA-selected platelet transfusions were more effective than HPA-unselected platelets but unselected platelets were often effective enough to achieve clinical goals. Available studies do not clearly demonstrate a benefit for addition of IVIg to platelet transfusion.
- Subjects :
- medicine.medical_specialty
Adrenal cortex hormones
Platelet Transfusion
03 medical and health sciences
0302 clinical medicine
Adrenal Cortex Hormones
030225 pediatrics
Internal medicine
Humans
Medicine
Platelet
030212 general & internal medicine
Fetus
Hematology
biology
Platelet Count
business.industry
Infant, Newborn
Recem nascido
Immunoglobulins, Intravenous
Obstetrics and Gynecology
medicine.disease
Combined Modality Therapy
Human platelet antigen
Thrombocytopenia, Neonatal Alloimmune
Fetal Diseases
Platelet transfusion
Anesthesia
Pediatrics, Perinatology and Child Health
Neonatal alloimmune thrombocytopenia
biology.protein
business
Intracranial Hemorrhages
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Journal of Perinatology, 39(10), 1329-1339. NATURE PUBLISHING GROUP
- Accession number :
- edsair.doi.dedup.....8d3307889eae7ea638fbdb733f37511a