Management of neonatal thrombocytopenia in a context of maternal antiplatelet alloimmunization: Expert opinion of the French-speaking working group

Bertrand, Gérald; Blouin, Laura; Boehlen, Françoise; Levine, Emmanuelle; Minon, Jean‐Marc; Winer, Norbert

doi:10.1016/j.arcped.2019.02.006

Cited by 8 publications

(4 citation statements)

References 48 publications

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“…Ultrasound findings in the case of intracranial hemorrhage are ventriculomegaly, clots within lateral ventricles, porencephaly, signs of severe anemia and hydrops [ 65 ] ( Figure 7 ). Due to increased risk of recurrence, active management initiated early in subsequent pregnancies might reduce the risks of morbidity and mortality from severe hemorrhage [ 114 , 115 , 116 ].…”

Section: Pathological Transfer Of Igg—alloimmune Disordersmentioning

confidence: 99%

Benefits and Risks of IgG Transplacental Transfer

et al. 2020

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Maternal passage of immunoglobulin G (IgG) is an important passive mechanism for protecting the infant while the neonatal immune system is still immature and ineffective. IgG is the only antibody class capable of crossing the histological layers of the placenta by attaching to the neonatal Fc receptor expressed at the level of syncytiotrophoblasts, and it offers protection against neonatal infectious pathogens. In pregnant women with autoimmune or alloimmune disorders, or in those requiring certain types of biological therapy, transplacental passage of abnormal antibodies may cause fetal or neonatal harm. In this review, we will discuss the physiological mechanisms and benefits of transplacental transfer of maternal antibodies as well as pathological maternal situations where this system is hijacked, potentially leading to adverse neonatal outcomes.

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Section: Pathological Transfer Of Igg—alloimmune Disordersmentioning

confidence: 99%

Benefits and Risks of IgG Transplacental Transfer

et al. 2020

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“…90,91,104,105,[112][113][114]118,119 Recently, a PC-based algorithm and the presence or absence of bleeding has been proposed by a task force for the indication of platelet transfusion, but it has not been validated in prospective studies. 120 If platelet units are not available, IVIG 119,121 is an option with the same mechanism described for autoimmune thrombocytopenia. Corticosteroids have not proven effective.…”

Section: Thrombocytopenia Caused By Alloantibodiesmentioning

confidence: 99%

Neonatal thrombocytopenia: A review. I. Definitions, differential diagnosis, causes, immune thrombocytopenia

Donato

2021

Arch Argent Pediat

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Thrombocytopenia, defined as a platelet count below 100 x 10 9 /L, is a very common finding in the neonatal period, especially in critically ill infants and preterm newborns. Its causes are multiple: it may be due both to pediatric conditions and to other factors involved in the fetal-placental-maternal interface. This initial article describes the causes of thrombocytopenia, proposes a diagnostic approach to manage a thrombocytopenic newborn infant, and provides a detailed description of the different conditions corresponding to thrombocytopenia of immune etiology. It also describes the different causative mechanisms and reviews the varying characteristics of thrombocytopenia secondary to maternal immune thrombocytopenia and neonatal alloimmune thrombocytopenia. The different treatment approaches to each of the different conditions are described both for their pre-as well as their postnatal management. The severity of thrombocytopenia and the serious complications and sequelae associated with the neonatal alloimmune thrombocytopenia are highlighted.

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“…90,91,104,105,[112][113][114]118,119 Recientemente, un grupo de trabajo ha propuesto, para la indicación de transfusión de plaquetas, un algoritmo basado en el RP y la presencia o no de hemorragias, pero aún no ha sido validado en estudios prospectivos. 120 En caso de no poder disponer de concentrados plaquetarios, una opción es la IGIV, 119,121 que actúa por el mismo mecanismo descrito para la trombocitopenia autoinmune. Los corticoides no se han mostrado efectivos.…”

Section: Trombocitopenia Por Aloanticuerposunclassified

Trombocitopenia neonatal: Revisión. I. Definiciones, diagnóstico diferencial, causas, trombocitopenias inmunes

2021

Arch Argent Pediat

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RESUMENLa trombocitopenia, definida como recuento plaquetario inferior a 100 x 10 9 /l, es un hallazgo muy frecuente en el período neonatal, que ocurre, en especial, en niños críticamente enfermos y en prematuros. Sus causas son múltiples: puede deberse tanto a enfermedades del niño como a otros factores involucrados en la interrelación niño-placenta-madre. En este primer artículo, se enumeran las causas de trombocitopenia; se plantea el enfoque diagnóstico frente a un neonato trombocitopénico y se describen detalladamente las distintas entidades correspondientes a trombocitopenias de etiología inmune. Se presentan los diferentes mecanismos causales y se revisan las distintas características de la trombocitopenia secundaria a trombocitopenia inmune materna y de la trombocitopenia neonatal aloinmune. Se describen las diversas estrategias terapéuticas disponibles para cada una de ellas, tanto para su manejo posnatal como para el prenatal. Se enfatiza sobre la gravedad de la enfermedad y las serias complicaciones y secuelas asociadas a la trombocitopenia neonatal aloinmune. Palabras clave: trombocitopenia neonatal, trombocitopenia inmune, púrpura trombocitpénica, trombocitopenia neonatal aloinmune, transfusión de plaquetas.

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Management of neonatal thrombocytopenia in a context of maternal antiplatelet alloimmunization: Expert opinion of the French-speaking working group

Cited by 8 publications

References 48 publications

Benefits and Risks of IgG Transplacental Transfer

Benefits and Risks of IgG Transplacental Transfer

Neonatal thrombocytopenia: A review. I. Definitions, differential diagnosis, causes, immune thrombocytopenia

Trombocitopenia neonatal: Revisión. I. Definiciones, diagnóstico diferencial, causas, trombocitopenias inmunes

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