Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a condition in which, during pregnancy, the mother develops antibodies that attack the platelets of the fetus. Platelets are a component of the red blood cells. Their primary function is to come together to form clots to stop bleeding when they occur.
Without adequately circulating levels of platelets, patients are at risk of prolonged episodes of bleeding. For example, while a cut to the leg from a sports injury may stop bleeding after a few minutes, an individual with platelet deficiency may continue to bleed, which can be dangerous.
The consequences of FNAIT
In the same way, fetuses and infants may experience internal bleeding that platelets are typically able to stem. However, without enough platelets, prolonged bleeding can occur.
Read more about FNAIT testing and diagnosis
Some of the symptoms of this are petechiae (purplish-pink spots on the skin) and bruising. You may notice these symptoms in a newborn child affected by FNAIT. The reason for these appearances is that there are not enough platelets to stop bleeding in time for these spots to not appear on the skin.
While these skin manifestations are typically harmless, a more serious issue is when internal bleeding occurs. Internal bleeding is bleeding in the organs that are not visible to the naked eye; despite this, prolonged bleeding can result in severe complications, including death.
Isolated ICH and FNAIT
In FNAIT, one of the most severe complications is intracranial hemorrhage (ICH). ICH is a condition in which bleeding occurs in the brain. However, the problem is that the skull is a contained space; it is not elastic, so there is only so much bleeding that it can hold before significant swelling occurs in the brain.
And this is the primary danger of ICH. Once bleeding is triggered for whatever reason, the blood continues to accumulate in the skull because it has nowhere else to go. This can cause severe complications, including brain damage or a restriction of the blood supply to the brain, otherwise known as a stroke. If untreated, this can be fatal.
The term “isolated ICH” just means that ICH is the only symptom present; hence, it is “isolated”. However, isolated ICH is precisely the least desired and the most dangerous complication of FNAIT.
Your doctor is likely aware of this risk, and all medical interventions are aimed at preventing this from occurring. One of the most common treatments in FNAIT, even before ICH occurs, is to transfuse the fetus/child with platelets to replace what is missing. Other treatments are also available to minimize the risk of ICH and other complications, including intravenous immunoglobulin and corticosteroids, which are given to the mother during pregnancy.
If you are worried about the risk of ICH, do speak to your doctor about your concerns. In most cases, your doctor is likely actively working towards preventing this from occurring from the very moment FNAIT is detected, even during pregnancy.
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