If you have experienced a pregnancy affected by fetal and neonatal alloimmune thrombocytopenia (FNAIT), you may be wondering about the risks of becoming pregnant again.
While you should always consult your doctor with questions about your health and risk factors for pregnancy, knowing about the risks of FNAIT in subsequent pregnancies can help you make an informed decision.
How serious is FNAIT?
Pregnancies affected by FNAIT are considered high-risk for very good reason. In essence, the problem lies in the depletion of platelet levels in the fetus and later the newborn. Without an adequate supply of platelets, any episodes of bleeding are likely to continue for a prolonged period of time. This can be very risky, especially if the bleeding occurs in the brain. This is otherwise known as an intracranial hemorrhage.
In intracranial hemorrhage, bleeding accumulates in the brain. An inadequate circulation of platelets means that the bleeding continues for an extended period of time. Given that there is limited space in the brain, excessive bleeding can cause it to swell. If medical interventions are not initiated, this can lead to death.
Read more about FNAIT treatment and care.
Why is FNAIT likely in subsequent pregnancies?
FNAIT is likely to be riskier in subsequent pregnancies because the mother’s immune response is likely to be stronger, resulting in an even more severe attack on a future fetus’s platelets. This can occur even if there were few to no symptoms of FNAIT during the first pregnancy.
Let’s break down what this means. In FNAIT, the mother’s immune system mistakenly identifies the fetus’s platelets as a foreign substances that must be removed. Typically, the immune system works by identifying infections and other truly foreign substances and then attacks them to ensure that you stay healthy. In FNAIT, the maternal immune system works against the fetus, destroying platelets.
In subsequent pregnancies, the maternal immune system retains memory of the “foreign” platelets, meaning that it is ready to mount an even more severe attack against them. This is known as “immune memory”.
In healthy individuals, immune memory is vital for the body to fight the same or similar diseases faster the next time it encounters them. Unfortunately, in subsequent pregnancies associated with FNAIT, the immune system’s mistake in identifying fetal platelets as “the enemy” persists, typically resulting in more risky subsequent pregnancies.
Taking precautions and making informed decisions
To fully understand the risks involved in subsequent pregnancies when you have a history of FNAIT, it is a good idea to talk with a doctor or genetic counselor who will be able to walk you through the ins and outs of the disease, as well as give you an idea about what to expect should you become pregnant again.
A future pregnancy will likely involve very close monitoring, which will allow your doctor to intervene medically if deemed necessary. Help is always available, and a well-monitored pregnancy can significantly reduce the risks typically associated with FNAIT.
Sign up here to get the latest news, perspectives, and information about FNAIT sent directly to your inbox. Registration is free and only takes a minute.
