Faculty Collaboration Database

Fetal and neonatal alloimmune thrombocytopenia in pregnancies involving in vitro fertilization: a report of four cases. Am J Obstet Gynecol 2005 Feb;192(2):543-7

Date

02/08/2005

Pubmed ID

15696000

DOI

10.1016/j.ajog.2004.09.006

Scopus ID

2-s2.0-13444280422 (requires institutional sign-in at Scopus site)   23 Citations

Abstract

OBJECTIVE: We report four cases of neonatal alloimmune thrombocytopenia (NATP) in pregnancies achieved with in vitro fertilization.

STUDY DESIGN: Three cases used surrogate carriers, and the fourth a donor egg. Sera from gestational carriers were tested for platelet antibodies by flow cytometry and enzyme-linked immunosorbent assay. Platelet antigen genotyping of biologic mothers, fathers, and surrogates was performed by amplification of DNA by using polymerase chain reaction with sequence-specific primers.

RESULTS: In all 4 cases, NATP resulted from an incompatibility between the fetus and gestational carrier for the platelet-specific alloantigen HPA-1a. Four infants were born severely thrombocytopenic (platelets <50,000/muL), 2 had antenatal intracranial hemorrhage, and 1 fetus expired in utero at 29 weeks.

CONCLUSION: NATP can occur in the setting of assisted reproductive technology. Because of the great costs, both financial and emotional, associated with these pregnancies, we strongly recommend that all women be typed for HPA-1a before serving as a surrogate mother.

Author List

Curtis BR, Bussel JB, Manco-Johnson MJ, Aster RH, McFarland JG

Author

Brian Curtis PhD Director in the Platelet & Neutrophil Immunology Laboratory department at BloodCenter of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Antigens, Human Platelet
Female
Fertilization in Vitro
Humans
Immunoglobulin G
Infant, Newborn
Integrin beta3
Middle Aged
Pregnancy
Thrombocytopenia