If your infant was diagnosed with fetal and neonatal alloimmune thrombocytopenia (FNAIT), you may have been surprised to find that being discharged from the hospital is not the end of your treatment journey. Even if an infant is well enough to go home, they still need to be monitored closely for symptoms.
This is because thrombocytopenia can persist for up to eight to 12 weeks. In most cases, the risk of complications post-discharge is low. However, if symptoms do reoccur, your infant may require urgent medical attention.
What is FNAIT?
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare but serious condition in which a pregnant mother’s immune system produces antibodies against the platelets of her fetus. This occurs when a fetus inherits platelet antigens from the father that are not compatible with the mother, typically involving a protein called human platelet antigen (HPA). The mother’s immune system recognizes the fetal platelets as foreign, attacking and destroying them, leading to low platelet levels (thrombocytopenia) in the fetus or newborn.
Post-discharge monitoring of FNAIT symptoms
Taking your baby home from the hospital for the first time is an emotional experience, particularly following a high-risk pregnancy or complicated birth. In babies affected by FNAIT, close monitoring is essential in case FNAIT symptoms reoccur or worsen.
While this may heighten your anxiety levels, it is important to remain vigilant and call your doctor if you notice any changes in symptoms, feeding patterns or behavior.
Learn more about FNAIT treatment and care
Why is there a risk of FNAIT symptoms reoccurring?
Maternal anti-HPA antibodies are gradually eliminated from the baby’s system post-delivery, reducing the risk of hemorrhage. However, they can persist in the baby’s bloodstream over a period of weeks to months and continue to affect the baby’s platelets. There is therefore a risk that bleeding or hemorrhage may occur, requiring medical intervention such as a platelet transfusion to boost platelet levels.
When to call the doctor
When you return home, your baby may have follow-up appointments and blood tests to check platelet levels. In addition, you will need to monitor your baby for the appearance of FNAIT-related symptoms and any changes in feeding or behavior.
In FNAIT-affected babies, platelet levels may continue to fall, and if they become dangerously low, it may lead to internal bleeding or intracranial hemorrhage. There are certain signs to look out for that are a cause for concern and require medical intervention.
These include:
- Unusual sleepiness or floppiness
- Seizures
- Persistent vomiting
- High-pitched crying
- Blood in vomit or stools
- Bleeding from gums or nose
- Unexplained and/or uncontrolled bleeding
- New bruises or pinprick rashes (petechiae)
- Poor feeding
- Irritability or fussiness
These symptoms can vary in severity, and even if you are not entirely sure, call your doctor anyway. Don’t wait for further confirmation. Mild symptoms can quickly grow more severe, and early intervention is an important factor in successful outcomes.
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