Diagnosing fetal and neonatal alloimmune thrombocytopenia (FNAITFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth.) can be complicated, as it often causes symptoms that can overlap with other conditions.
In newborns, before platelets are tested, certain symptoms may initially point to cardiac or respiratory distress. Even so, your healthcare team is trained to consider symptoms as part of a bigger picture, and when more common diagnoses are ruled out, they may consider additional tests for less common conditions like FNAIT.
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FNAIT symptoms that can mimic cardiac distress symptoms
In newborns, symptoms of FNAIT can be diverse and at times non-specific when considered alone. They may include a combination of the following: pale skin, bruising, red or purple pinprick spots on the skin, fussiness, lethargy, poor feeding, trouble breathing, seizures, bleeding from the umbilical cord or black stools.
Symptoms of cardiac distress that are similar to those of FNAIT include pale skin, feeding difficulties, lethargy, seizures and trouble breathing.
However, looking at symptoms separately cannot lead to diagnosis, so comprehensive testing is required to ensure a correct diagnosis, timely treatment and the best outcomes.
Tests used to diagnose FNAIT
If you have any of the above-mentioned symptoms, report them to your doctor immediately, and they will determine the cause, as many of them could be caused by various conditions like FNIAT, cardiac distress, infection, anemia or a respiratory disease.
Your doctor may use one or more of the following tests to identify the underlying cause of your symptoms:
Blood test
Your doctor may recommend a blood test to check your full blood count and platelet levels. In FNAIT, the platelet countPlatelet count A measure of how many platelets are in the blood. FNAIT is characterized by severely reduced counts in a fetus or newborn. is key, as a low platelet count or thrombocytopeniaThrombocytopenia A platelet count that is lower than normal. can indicate blood loss or ongoing bleeding. Specialized testing for platelet antibodies takes longer and isn’t part of initial testing to determine treatment.
Imaging
An MRI, CT scan or ultrasound can be used to identify internal bleedingFetal hemorrhage Any bleeding that occurs before birth. In FNAIT, this usually results from extremely low platelet counts. in the gastrointestinal system, brain and lungs. A brain bleedBrain bleed Bleeding inside the fetal brain, also known as an intracranial hemorrhage. In FNAIT, it's often caused by severe thrombocytopenia and can lead to long-term disability or death. , also known as an intracranial hemorrhageBrain bleed Bleeding inside the fetal brain, also known as an intracranial hemorrhage. In FNAIT, it's often caused by severe thrombocytopenia and can lead to long-term disability or death. , is the most dangerous potential complication of FNAIT, and it could lead to long-term brain damage and even death if left untreated.
Oxygen saturation test
Using a pulse oximeter, doctors measure the oxygen level in the baby’s blood. A low reading can point to heart or lung problems.
Echocardiogram
An ultrasound of the baby’s heart is key in diagnosing heart related issues.
ECG
Testing the electrical activity of the baby’s heart can identify abnormal heart rates and irregular heartbeats
An accurate diagnosis is made by observing the evolution of the newborn’s symptoms and analyzing the results from the various tests.
