Subamniotic Hemorrhage, a Possible New Presentation of Fetal and Neonatal Alloimmune Thrombocytopenia

Publication date

2022-04

Authors

Giesbers, Steven
Bos, Manon
Bulten, Johan
van der Meeren, Lotte E
van Drongelen, Joris

Editors

Advisors

Supervisors

Document Type

Article

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License

cc_by_nc

Abstract

BACKGROUND: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare fetal disease in which maternal antibodies directed toward fetal human platelet antigens (HPA) are formed during pregnancy and cause fetal thrombocytopenia. The diagnosis FNAIT is suspected when a fetus or neonate presents with signs of bleeding. CASE: We describe a pregnancy complicated by a placental hematoma in the 20th week of gestation as the first manifestation of FNAIT. Further evaluation showed signs of germinal matrix hemorrhage and HPA-5b allo-antibodies. After the diagnosis, intravenous immunoglobulin was administered weekly and a healthy daughter was born at 37 weeks. Histopathological analysis revealed that the hematoma was caused by a subamniotic hemorrhage of fetal origin. CONCLUSION: A subamniotic hematoma appears to be the first manifestation of FNAIT.

Keywords

Allo-antibodies, Fetal and neonatal alloimmune thrombocytopenia, Hematoma, Human platelet antigens-5b, Placenta, Subamniotic, Obstetrics and Gynaecology, Radiology Nuclear Medicine and imaging, Pediatrics, Perinatology, and Child Health, Embryology, Case Reports

Citation

Giesbers, S, Bos, M, Bulten, J, van der Meeren, L & van Drongelen, J 2022, 'Subamniotic Hemorrhage, a Possible New Presentation of Fetal and Neonatal Alloimmune Thrombocytopenia', Fetal Diagnosis and Therapy, vol. 49, no. 1-2, pp. 60-64. https://doi.org/10.1159/000521866