Managing patients with fetal/neonatal alloimmune thrombocytopenia

Why did ICTMG develop a guideline for FNAIT?

Fetal and neonatal alloimmune thrombocytopenia (FNAIT) may result in severe bleeding, particularly fetal and neonatal intracranial haemorrhage. As a result, FNAIT requires prompt identification and treatment; subsequent pregnancies need close surveillance and management.

 

ICTMG's recommendations provide guidance on the antenatal and postnatal management of FNAIT for haematologists, maternal fetal medicine specialists, immunologists, transfusion medicine specialists, paediatricians and neonatologists.

How to access the ICTMG Publications

ICTMG developed three systematic reviews and a guideline on the management of fetal and neonatal alloimmune thrombocytopenia.

  • Jillian M. Baker, Nadine Shehata, James Bussel, Michael F. Murphy, Andreas Greinacher, Tamam Bakchoul, Edwin Massey, Lani Lieberman, Denise Landry, Susano Tanael, Donald M. Arnold, Shoma Baidya, Gerald Bertrand, Mette Kjaer, Cécile Kaplan, Jens Kjeldsen-Kragh, Dick Oepkes, Helen Savoia, Greg Ryan, Heather Hume & on behalf of the International Collaboration for Transfusion Medicine Guidelines (ICTMG). Postnatal intervention for the treatment of FNAIT: a systematic review.  Journal of Perinatology (2019) 39: 1329–1339.

ICTMG's guideline on the management of patients with fetal and neonatal alloimmune thrombocytopenia was published in British Journal of Haematology in 2019:

 

  • To download a pdf of the article click here.

ICTMG conducted a systematic review and meta-analysis to determine the association between maternal HLA-DRB3*01:01 and: (1) HPA-1a-alloimmunization and (2) neonatal outcome in children born of HPA-1a-immunized women. This systematic review was published open-access in Blood Advances in August 2020:

  • To download a pdf of the article click here.

Additional resources for physicians

Podcast for physicians - FNAIT Guideline 

Listen to Dr. Richard Wells, hematologist, in conversation with Dr. Donnie Arnold, hematologist, and Dr. Dick Oepkes, obstetrician and maternal fetal medicine specialist.

In this 2-Part podcast, they discuss management of FNAIT and is intended to provide guidance on the antenatal and postnatal testing and screening for FNAIT.  This podcast complements the two systematic reviews published in Blood and Vox Sanguinis (see publications above).

Fetal and Neonatal Alloiummune Thrombocytopenia: Recommendations for Evidence Based Practice, an International Approach

Please use or adapt our presentation for education or training purposes.  Download the slide deck here.

Antenatal Algorithm

Print out the decision-making algorithm summarizing ICTMG’s recommendations for managing pregnant women with previous FNAIT during the antenatal period. It can be used by haematologists, maternal fetal medicine specialists, immunologists, transfusion medicine specialists, paediatricians and neonatologists.

Postnatal Algorithm

Print out the decision-making algorithm summarizing ICTMG’s for managing neonate with suspected FNAIT. It can be used by haematologists, maternal fetal medicine specialists, immunologists, transfusion medicine specialists, paediatricians and neonatologists.

Additional resources for patients

Podcast for patients - FNAIT:  Questions and Answers for Patients

Listen to a conversation between Drs. Lani Lieberman, Jens Kjeldsen-Kragh, and Michael F. Murphy, physicians with FNAIT expertise, and Sarah Bloom and Fazeela Khan, patients affected by FNAIT.

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They answer questions such as “what is FNAIT?” and discuss treatments in pregnancies affected by FNAIT. It complements the patient pamphlets published by ICTMG on this website.

Patient Pamphlets - FNAIT:  Patient information

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