|
|
Blood, 1 August 2007, Vol. 110, No. 3, pp. 833-839.
Prepublished online as a Blood First Edition Paper on April 11, 2007; DOI 10.1182/blood-2006-08-040121.
 Previous Article | Next Article 
Submitted August 7, 2006
Accepted April 3, 2007
A screening and intervention program aimed to reduce
mortality and serious morbidity associated with severe
neonatal alloimmune thrombocytopenia
Jens Kjeldsen-Kragh*, Mette Kjaer Killie, Geir Tomter, Elzbieta Golebiowska, Ingrid Randen, Reidun Hauge, Berit Aune, Pal Oian, Lauritz B Dahl, Jouko Pirhonen, Rolf Lindeman, Henrik Husby, Guttorm Haugen, Morten Gronn, Bjorn Skogen, and Anne Husebekk
Department of Immunology and Transfusion Medicine, Ulleval University Hospital, Oslo, Norway
Department of Immunology and Transfusion Medicine, University Hospital of North Norway, Tromso, Norway
Faculty Division Ulleval University Hospital, University of Oslo, Oslo, Norway
Institute of Medical Biology, University of Tromso, Tromso, Norway
Institute of Clinical Medicine, University of Tromso, Tromso, Norway
Department of Pediatrics, University Hospital of North Norway, Tromso, Norway
Department of Obstetrics and Gynecology, Ulleval University Hospital, Oslo, Norway
Department of Pediatrics, Ulleval University Hospital, Oslo, Norway
Faculty Division Rikshospitalet, University of Oslo, Oslo, Norway
Department of Obstetrics and Gynecology, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway
Department of Pediatrics, Rikshospitalet-Radiumhospitalet Medical Centre, Oslo, Norway
Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromso, Norway
* Corresponding author; email: jens.kjeldsen-kragh{at}medisin.uio.no.
The study's objective was to identify HPA 1a negative women, and to offer them an intervention program aimed to reduce morbidity and mortality of neonatal alloimmune thrombocytopenia (NAIT). HPA 1 typing was performed in 100,448 pregnant women. The HPA 1a negative women were screened for anti-HPA 1a. In immunized women, delivery was performed by Caesarean section 2-4 weeks prior to term with platelets from HPA 1a negative donors reserved for immediate transfusion if petechiae were present and/or if platelet count was <35x109/L. Two-point-one percent of the women were HPA 1a negative and anti HPA 1a was detected in 10.6% of these. One-hundred-and-seventy pregnancies were managed according to the intervention program, resulting in 161 HPA 1a positive children. Of these, 55 had severe thrombocytopenia (<50x109/L) including two with intracranial hemorrhage (ICH). One woman with a twin pregnancy missed the follow up and had one stillborn and one severely thrombocytopenic live child. In 15 previous prospective studies (136,814 women) there were 51 cases of severe NAIT (3 intrauterine deaths and 7 with ICH). Acknowledging the limitation of comparing with historic controls, implementation of our screening and intervention program seemed to reduce the number of cases of severe NAIT-related complications from 10/51 to 3/57.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
M Wilke, I Muller-Hansen, D Wernet, T Nagele, and C F Poets
Severe bilateral intracranial haemorrhage due to alloimmune thrombozytopenia in a premature infant
Arch. Dis. Child. Fetal Neonatal Ed.,
November 1, 2009;
94(6):
F427 - F428.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. T. Ahlen, A. Husebekk, M. K. Killie, B. Skogen, and T. B. Stuge
T-cell responses associated with neonatal alloimmune thrombocytopenia: isolation of HPA-1a-specific, HLA-DRB3*0101-restricted CD4+ T cells
Blood,
April 16, 2009;
113(16):
3838 - 3844.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Kjeldsen-Kragh, M. Kim, M. K. Killie, A. Husebekk, J. Freedman, and J. W. Semple
In HPA 1a-immunized women the decrease in anti-HPA 1a antibody level during pregnancy is not associated with anti-idiotypic antibodies
Haematologica,
March 1, 2009;
94(3):
441 - 443.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Kaplan
Neonatal alloimmune thrombocytopenia
Haematologica,
June 1, 2008;
93(6):
805 - 807.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. K. Killie, A. Husebekk, J. Kjeldsen-Kragh, and B. Skogen
A prospective study of maternal anti-HPA 1a antibody level as a potential predictor of alloimmune thrombocytopenia in the newborn
Haematologica,
June 1, 2008;
93(6):
870 - 877.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
