Review
Obstetrics & Gynecology
James B. Bussel, Emilie L. Vander Haar, Richard L. Berkowitz
Summary: Advances in managing fetal and neonatal alloimmune thrombocytopenia may include screening all antepartum patients, noninvasively testing fetal human platelet antigen 1 genotype, developing a prophylactic product equivalent to Rh immune globulin, and creating neonatal Fc receptor inhibitors as potential therapies.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2021)
Review
Medicine, General & Internal
Jens Kjeldsen-Kragh, Gregor Bein, Heidi Tiller
Summary: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare condition in which maternal alloantibodies to fetal platelets cause fetal thrombocytopenia. Intravenous immunoglobulin (IVIg) is the standard treatment for this condition, but its necessity for all immunized pregnant women at risk of having a child with FNAIT is still uncertain.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Obstetrics & Gynecology
Siw L. Ernstsen, Maria T. Ahlen, Tiril Johansen, Eirin L. Bertelsen, Jens Kjeldsen-Kragh, Heidi Tiller
Summary: This study compared the outcomes of pregnancies with anti-human platelet antigen-1a-induced intracranial hemorrhage treated with intravenous immunoglobulin versus pregnancies without this treatment. The results showed that omitting antenatal intravenous immunoglobulin treatment in low-risk pregnancies does not increase the risk of neonatal intracranial hemorrhage.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Article
Hematology
Assaf Barg, Lilach Bonstein
Summary: This review discusses the advances in the field of fetal and neonatal alloimmune thrombocytopenia (FNAIT), including new methods for prenatal diagnosis and treatment. Topics explored include noninvasive prenatal testing, novel therapeutic options developed through the use of mouse models, and research on the biological characteristics of alloantibodies and their association with the risk of fetal bleeding.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2023)
Article
Obstetrics & Gynecology
Thijs W. de Vos, Masja de Haas, Dick Oepkes, Ratna N. G. B. Tan, C. Ellen van der Schoot, Sylke J. Steggerda, Linda S. de Vries, Enrico Lopriore, Jeanine M. M. van Klink
Summary: This study aimed to evaluate the long-term neurodevelopmental outcomes in children with fetal and neonatal alloimmune thrombocytopenia who were treated with antenatal intravenous immunoglobulin. The results showed that the risk of neurodevelopmental impairment in these children is comparable to that reported in the general population.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Article
Hematology
Christof Geisen, Mette Kjaer, Erika Fleck, Bjorn Skogen, Roisin Armstrong, Frank Behrens, Zubin Bhagwagar, Susanne Braeuninger, Anette Mortberg, Klaus Juel Olsen, Stephan Martin Gaston Schaefer, Carmen Walter, Erhard Seifried, Agneta Wikman, Jens Kjeldsen-Kragh, Michaela Koehm
Summary: This study investigated whether a single dose of anti-HPA-1a could accelerate the elimination of HPA-1ab platelets in healthy participants. The results showed that anti-HPA-1a significantly accelerated the elimination of HPA-1ab platelets in all participants, supporting its potential use in the prevention and treatment of FNAIT in pregnant women at risk.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Biochemistry & Molecular Biology
Thijs W. de Vos, Dian Winkelhorst, Hans J. Baelde, Kyra L. Dijkstra, Rianne D. M. van Bergen, Lotte E. van der Meeren, Peter G. J. Nikkels, Leendert Porcelijn, C. Ellen van der Schoot, Gestur Vidarsson, Michael Eikmans, Rick Kapur, Carin van der Keur, Leendert A. Trouw, Dick Oepkes, Enrico Lopriore, Marie-Louise P. van der Hoorn, Manon Bos, Masja de Haas
Summary: This study found that untreated FNAIT cases showed more C4d deposition in the placenta, which may impact placental function and fetal growth. Histopathological examination revealed a certain proportion of placental delayed maturation in these cases.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Review
Hematology
Wendy Stam, Gabriela Elis Wachholz, Jose Maria de Pereda, Rick Kapur, Ellen van der Schoot, Coert Margadant
Summary: FNAIT is a pregnancy-associated condition caused by maternal alloantibodies against paternally-inherited platelet antigens, most frequently HPA-1a on integrin beta 3. The clinical effects range from no symptoms to fatal intracranial hemorrhage, but underlying pathophysiological determinants are poorly understood.
Article
Pediatrics
Thijs W. de Vos, Maud van Zagten, Masja de Haas, Dick Oepkes, Ratna N. G. B. Tan, C. Ellen van der Schoot, Sylke J. Steggerda, Linda S. de Vries, Enrico Lopriore, Jeanine M. M. van Klink
Summary: This observational cohort study evaluated the neurodevelopmental outcome at school age in children newly diagnosed with fetal and neonatal alloimmune thrombocytopenia (FNAIT). The results showed that children with newly diagnosed FNAIT are at increased risk for long-term neurodevelopmental problems, even those without intracranial hemorrhage.
JOURNAL OF PEDIATRICS
(2023)
Article
Medicine, General & Internal
Jing Fu, Ruojin Yao, Wenjing Yong
Summary: This study reported a case of prenatal diagnosis and treatment of FAIT. The patient presented with severe fetal anemia and thrombocytopenia at 32 weeks of gestational age. Following treatment with dexamethasone, the newborn's platelet count gradually increased to a normal level.
Article
Cell Biology
Rebecca Carter, Anna-Kaisa Niemi
Summary: Noonan syndrome is a genetic disorder with distinctive physical features and often involves bleeding disorders. This case report presents a neonate with intracranial hemorrhage and severe thrombocytopenia, found to have both NAIT and a de novo heterozygous pathogenic variant in PTPN11, consistent with Noonan syndrome.
Article
Hematology
Zachary A. Colvin, Jennifer Schiller, Shirng-Wern Tsaih, Ruchika Sharma, Rachael F. Grace, Jennifer J. McIntosh, Brian R. Curtis
Summary: This study examined whether suspected cases of fetal and neonatal alloimmune thrombocytopenia (FNAIT) without maternal human platelet antigens (HPA) antibodies had different human leukocyte antigen (HLA) antibody strength and specificity compared to controls. The results showed that FNAIT cases had significantly higher HLA antibody strength and broader HLA antibody specificity compared to matched controls.
Article
Hematology
Kristine Matusiak, Christopher J. Patriquin, Stacy Deniz, Nancy Dzaja, James W. Smith, Grace Wang, Ishac Nazy, John G. Kelton, Donald M. Arnold
Summary: This study investigated clinical and laboratory predictors of severe FNAIT and found that maternal antibodies to HPA were the only independent predictor of severe FNAIT in subsequent pregnancies. However, one infant had a severe FNAIT recurrence without maternal antibodies, highlighting the need for improved prevention and treatment strategies.
Article
Immunology
Zoltan Szittner, Arthur E. H. Bentlage, A. Robin Temming, David E. Schmidt, Remco Visser, Suzanne Lissenberg-Thunnissen, Juk Yee Mok, Wim J. E. van Esch, Myrthe E. Sonneveld, Erik L. de Graaf, Manfred Wuhrer, Leendert Porcelijn, Masja de Haas, C. Ellen van der Schoot, Gestur Vidarsson
Summary: The core fucosylation in anti-HPA-1a IgG greatly influences its binding to leukocyte IgG-Fc receptors IIIa/b. A cellular surface plasmon resonance imaging technique was developed to quantify the biological activity of IgG antibodies targeting cells.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Obstetrics & Gynecology
Sebastian Blanco, Laura C. Vega, Luis H. Carrizo, Jorge M. Culasso, Sandra Gallego
Summary: This report emphasizes the importance of early diagnosis of FNAIT and the need for programs to identify high-risk pregnancies in order to reduce complications in fetuses and newborns. Molecular tools were used to confirm FNAIT cases and detect anti-HPA antibodies.
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
(2022)
Article
Obstetrics & Gynecology
A. Zhang, T. T. Stolk, E. Lopriore, L. Sun, T. Duan, D. Oepkes
Summary: This study found that second-trimester abdominal circumference discordant monochorionic twins are at increased risk of adverse perinatal outcomes, including abnormal umbilical artery and ductus venosus flow, low birth weight, birth weight discordance, intrauterine fetal demise, and severe neonatal morbidity. Early and intensified fetal surveillance for these twins is necessary to improve perinatal outcomes.
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
(2022)
Letter
Pediatrics
M. J. A. van de Sande, E. Lopriore, E. J. T. Verweij, C. de Bruin, F. Slaghekke, L. S. A. Tollenaar
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Article
Obstetrics & Gynecology
Sophie G. Groene, Enrico Lopriore
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2023)
Article
Hematology
Linda M. Henricks, Elise J. Huisman, Enrico Lopriore, Jessie S. Luken, Masja de Haas, Claudia S. Ootjers, Arjan Albersen
Summary: In this case, a preterm neonate experienced an acute hemolytic reaction due to the administration of plasma product containing auto-antibodies. This adds a new argument to the discussion on expanding the use of solvent/detergent-treated plasma to the pediatric population.
TRANSFUSION MEDICINE
(2023)
Article
Pediatrics
Alexandra Scrivens, Nora Johanna Reibel, Lisanne Heeger, Simon Stanworth, Enrico Lopriore, Helen New, Christof Dame, Karin Fijnvandraat, Emoke Deschmann, Marta Aguar, Kristin Braekke, Francesco Stefano Cardona, Filip Cools, Ryan Farrugia, Stefano Ghirardello, Jana Lozar, Katarina Matasova, Tobias Muehlbacher, Ulla Sankilampi, Henrique Soares, Miklos Szabo, Tomasz Szczapa, Gabriela Zaharie, Charles Christoph Roehr, Suzanne Fustolo-Gunnink
Summary: This survey found significant variation in transfusion practices among NICUs in Europe, with liberal thresholds for transfusion compared to recent trial data. There is a need for further research to understand the barriers and enablers to incorporating recent trial findings into neonatal transfusion practice.
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Article
Pediatrics
Hylke H. Salverda, Janneke Dekker, Enrico Lopriore, Peter A. Dargaville, Steffen C. Pauws, Arjan B. te Pas
Summary: The effect of two different automated oxygen control devices on the time preterm infants spent in different ranges of oxygen saturation was compared in this study. The results showed that infants under OxyGenie control spent more time within the target range of oxygen saturation and less time in hypoxic and hyperoxic ranges.
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Article
Hematology
Sophie J. Jansen, Isabelle M. C. Ree, Lana Broer, Derek de Winter, Masja de Haas, Vincent Bekker, Enrico Lopriore
Summary: This study aimed to investigate the frequency of central-line use, indications for insertion, and the incidence of sepsis among neonates with hemolytic disease of the fetus and newborn (HDFN). The results showed that central-line placement was associated with an increased risk of sepsis and late-onset infection. This suggests that central-line placement should be delayed until the likelihood of exchange transfusion is high.
Article
Pediatrics
Carmel Maria Moore, Angela D'Amore, Suzanne Fustolo-Gunnink, Cara Hudson, Alice Newton, Beatriz Lopez Santamaria, Alison Deary, Renate Hodge, Valerie Hopkins, Ana Mora, Charlotte Llewelyn, Vidheya Venkatesh, Rizwan Khan, Karen Willoughby, Wes Onland, Karin Fijnvandraat, Helen New, Paul Clarke, Enrico Lopriore, Timothy Watts, Simon Stanworth, Anna Curley
Summary: This study aims to assess mortality and neurodevelopmental outcomes in children participating in the PlaNeT-2/MATISSE study at 2 years of corrected age. The results show that a higher platelet transfusion threshold is associated with significantly increased mortality or major bleeding compared to a lower one. This further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants.
ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION
(2023)
Editorial Material
Obstetrics & Gynecology
Enrico Lopriore
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2023)
Article
Obstetrics & Gynecology
Salma El Emrani, Sophie G. Groene, Jip A. Spekman, Femke Slaghekke, Lotte E. van der Meeren, Nicoline E. Schalij-Delfos, Enrico Lopriore
Summary: The study aimed to evaluate the difference in retinopathy of prematurity (ROP) between donors and recipients with twin-to-twin transfusion syndrome (TTTS) and identify risk factors for ROP development. The rates of any stage ROP and severe ROP were significantly higher in donors compared to recipients. Donor status, lower gestational age at birth, and longer mechanical ventilation days were independently associated with the occurrence of any stage ROP. Donor status was also associated with the occurrence of severe ROP. Increased awareness for ROP is needed in donors, especially those with lower gestational age at birth and longer duration of mechanical ventilation.
FETAL DIAGNOSIS AND THERAPY
(2023)
Article
Pediatrics
Jip A. Spekman, Salma El Emrani, Nicoline E. Schalij-Delfos, Femke Slaghekke, Jeanine M. M. van Klink, Enrico Lopriore, Sophie G. Groene
Summary: Research investigates the effect of fetal growth restriction (FGR) on retinopathy of prematurity (ROP) in growth-discordant identical twins, controlling for confounding factors. Results show that FGR is associated with almost tripled odds of ROP development, suggesting that unfavorable antenatal growth conditions and adverse neonatal outcomes affect postnatal retinal vascular proliferation.
PEDIATRIC RESEARCH
(2023)
Editorial Material
Pediatrics
Enrico Lopriore
Review
Obstetrics & Gynecology
Derek P. de Winter, Allysen Kaminski, May Lee Tjoa, Dick Oepkes, Enrico Lopriore
Summary: There is limited knowledge regarding the frequency of postnatal treatment and clinical outcomes of neonates with hemolytic disease of the fetus and newborn (HDFN). This study aimed to evaluate the postnatal treatment landscape and clinical outcomes in neonates with Rhesus factor D (Rh(D))- and/or K-mediated HDFN. The findings highlight a shortage and inconsistency in the reporting of relevant data and provide recommendations for future research.
BMC PREGNANCY AND CHILDBIRTH
(2023)
Article
Obstetrics & Gynecology
Patricia J. C. Knijnenburg, Femke Slaghekke, Chinar Rahmattulla, Yuchun Ge, Irene M. Scholl, Jeanine M. M. van Klink, Monique C. Haak, Johanna M. Middeldorp, Luming Sun, Enrico Lopriore
Summary: This study retrospectively assessed the prevalence, risk factors, and outcomes of intertwin membrane perforation and subsequent cord entanglement after laser surgery for twin-twin transfusion syndrome (TTTS). The results showed that 16% of TTTS pregnancies treated with laser surgery experienced intertwin membrane perforation, and this led to cord entanglement in 21% of cases. Intertwin membrane perforation was associated with higher laser power settings, a second fetal surgery procedure, higher rate of cesarean section, lower gestational age at birth, and a higher risk of severe cerebral injury.
FETAL DIAGNOSIS AND THERAPY
(2023)
Review
Medicine, General & Internal
Mathies Rondagh, Enrico Lopriore, Linda S. de Vries, Femke Slaghekke, Lisanne S. A. Tollenaar, Jeanine M. M. van Klink, Sophie G. Groene, Sylke J. Steggerda
Summary: The distinct placental angioarchitecture in monochorionic pregnancies increases the risk of complications, such as twin-twin transfusion syndrome, twin anemia polycythemia sequence, and selective fetal growth restriction. This systematic review evaluates the incidence and severity of cerebral injury and structural brain development in MC twins with or without complications. More research and standardized protocols are needed to enhance our understanding of these risks and pathophysiological mechanisms.
JOURNAL OF CLINICAL MEDICINE
(2023)