If your baby has experienced symptoms like unexplained bruising or bleeding, low platelet levels or discoloration of the skin, they may have had a rare serious but condition called Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT).
FNAIT is an immune disorder that occurs when a mother’s immune cells mistake her baby’s platelets (the cells that help with blood clotting) for foreign invaders and attack them in the womb. This can result in dangerously low platelet counts for the fetus and cause bleeding and ruptured blood vessels. In the most severe cases, bleeding can occur in major organs, including the brain or gastrointestinal tract.
While FNAIT can be diagnosed during pregnancy, in many cases, it’s not detected until after a baby is born with unusual bruising, discoloration or bleeding. Sometimes it may not be recognized at all.
If you suspect your child may have had undiagnosed FNAIT, here’s what to know and what you can do.
Talk to your doctor
The first thing you should do if you think your baby may have undiagnosed FNAIT is to talk to your pediatrician.
Before the appointment, gather as much of your baby’s medical records as you can. Information that’s helpful to have includes:
- Platelet counts at birth
- Notes on symptoms like bruising or bleeding
- Ultrasounds or brain imaging
- Lab results
- Any blood transfusions or platelet transfusions given
Your pediatrician may refer you to a pediatric hematologist, a doctor who specializes in blood disorders, who can further examine your baby and make a diagnosis.
Learn more about FNAIT prognosis
Why FNAIT may be missed
Babies with FNAIT have the best outcomes when the disorder is detected and treated early. However, because it is a rare disease, affecting 0.1% of pregnancies, it’s not yet part of standard prenatal testing and can often be missed. Rather, testing is offered when there’s a known or suspected history of FNAIT, such as from a previous pregnancy or family history of the condition.
Risks of undiagnosed FNAIT
While some babies with FNAIT recover without major issues, others may suffer significant complications. These include excessive bruising or bleeding, including bleeds in major organs like the brain, known as an intracranial hemorrhage. This can be severe and lead to long-term neurological damage or even death.
This is why if you suspect FNAIT, it’s important to talk to your pediatrician.
Discuss FNAIT risk with your doctor before your next pregnancy
If you’ve had a previous pregnancy affected by FNAIT, it’s important to talk to your doctor before future pregnancies.
Both you and your partner can get tested for a certain protein called HPA-1a, which is the most common trigger for FNAIT. If you are HPA-1a negative and your partner is HPA-1a positive, there’s a risk that your immune system could see your baby’s HPA-1a platelets as foreign and attack them.
A maternal-fetal medicine (MFM) specialist can help you with treatments during pregnancy that can significantly reduce the risk of complications in future babies.
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