Kaplan C, Morel-Kopp M C, Forestier F, Dreyfus M, Daffos F, Tchernia G
Institut National de Transfusion Sanguine, Service d'Immunologie Leuco-Plaquettaire, Paris, France.
Pathol Biol (Paris). 1994 Oct;42(8):783-9.
Fetal/neonatal immune thrombocytopenias result from increased platelet destruction by maternal antiplatelet antibodies. There is a risk of intracerebral haemorrhage and therefore of neurological impairment or death during the thrombocytopenic period, especially if a defective platelet function co-exists. As no maternal parameter is predictive of the fetal platelet count, the only reliable assessment of the fetal status depends on the fetal blood sampling. Only in case of materno-fetal alloimmunisation the therapy initiated to reverse fetal thrombocytopenia was shown to be effective, but the optimal mode of antenatal treatment is currently under study. As the neonatal therapy and the management of subsequent pregnancies are somehow different it is mandatory to make the distinction between the auto or allo-origin of the fetal thrombocytopenia. The definition of high risk pregnancies will be of help for the development of a routine screening program.
胎儿/新生儿免疫性血小板减少症是由母体抗血小板抗体导致血小板破坏增加引起的。存在脑出血风险,因此在血小板减少期有神经功能损害或死亡风险,尤其是当同时存在血小板功能缺陷时。由于没有母体参数可预测胎儿血小板计数,对胎儿状况的唯一可靠评估取决于胎儿血样采集。仅在母胎同种免疫的情况下,为逆转胎儿血小板减少症而启动的治疗被证明是有效的,但目前正在研究产前治疗的最佳模式。由于新生儿治疗及后续妊娠的管理在某种程度上有所不同,区分胎儿血小板减少症的自身或同种起源至关重要。高危妊娠的定义将有助于制定常规筛查计划。