Fetal thrombocytopenia in pregnancies complicated by fetal anemia due to red-cell alloimmunization: cohort study and meta-analysis

To estimate the prevalence and characteristics of fetal thrombocytopenia at the time of percutaneous umbilical cord sampling (PUBS) in pregnancies complicated by alloimmunization and to conduct a systematic review on fetal thrombocytopenia in these pregnancies. Retrospective cohort study of all pati...

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Bibliographic Details
Published in:Journal of perinatology 2019-07, Vol.39 (7), p.920-926
Main Authors: Rosenbloom, Joshua I, Bruno, Ann M, Conner, Shayna N, Tuuli, Methodius G, Simon, Laura E, Macones, George A, Cahill, Alison G
Format: Article
Language:English
Subjects:
Anemia
Anemia - diagnosis
Anemia - etiology
Antigens, Human Platelet - immunology
Blood Group Incompatibility - complications
Cohort analysis
Confidence intervals
Female
Fetal Blood - cytology
Fetal Diseases - etiology
Fetoscopy
Fetuses
Gestational Age
Humans
Isoimmunization
Meta-analysis
Patients
Platelet Count
Platelets
Pregnancy
Pregnancy Complications, Hematologic
Retrospective Studies
Statistical analysis
Systematic review
Thrombocytopenia
Thrombocytopenia - diagnosis
Thrombocytopenia - etiology
Thrombocytopenia - immunology
Transfusion
Umbilical cord
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Summary:To estimate the prevalence and characteristics of fetal thrombocytopenia at the time of percutaneous umbilical cord sampling (PUBS) in pregnancies complicated by alloimmunization and to conduct a systematic review on fetal thrombocytopenia in these pregnancies. Retrospective cohort study of all patients undergoing PUBS at our institution from 2000-2017. Clinical data, including fetal platelet counts, were abstracted from the medical record and analyzed with routine statistical procedures. A systematic review and meta-analysis were also conducted according to standard procedures. At first procedure, prior to any transfusion, 13/36 fetuses (36%) had thrombocytopenia: 11/36 (31%) had moderate thrombocytopenia and 2/36 (6%) had severe thrombocytopenia (14 patients had no platelet count at first procedure). The systematic review identified six studies, and the prevalence of fetal thrombocytopenia at the time of PUBS for alloimmunization was 18% (95% confidence interval 11%, 26%). Thrombocytopenia is common and underappreciated in fetuses undergoing PUBS for alloimmunization.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-019-0388-8