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Fetal and neonatal alloimmune thrombocytopenia (FNAIT) occurs when fetal platelets are sensitized and then phagocytized by macrophages in the reticuloendothelial system after antibodies specific for allogeneic platelets in the pregnant women cross the placenta and enter the fetus. In severe cases, intracranial hemorrhage and even fetal death may occur. This article reviews the recent progress in the following aspects: the mechanisms of pregnancy-related platelet alloimmunity, platelet destruction mechanisms in FNAIT, correlation of anti-angiogenic effects and intracranial hemorrhage, correlation between anti-GPIbα antibodies and miscarriage, and the diagnosis, treatment and prevention of FNAIT.
RESUMEN
Hemolytic disease in fetuses and newborns (HDFN) is a common perinatal condition caused by the destruction of erythrocytes of neonates or fetuses by maternal IgG antibodies.Fetal or neonatal hemolysis is HDFN's primary pathological process resulting in anemia and neonatal jaundice.This review summarized recent progress in the pathophysiology of HDFN,the clinical correlation between anti-erythrocyte alloantibodies and HDFN,laboratory tests for alloimmunization in pregnancy,clinical evaluation of high-risk cases of HDFN,and treatment and prevention of HDFN at home and abroad.
RESUMEN
Hemolytic disease in fetuses and newborns (HDFN) is a common perinatal condition caused by the destruction of erythrocytes of neonates or fetuses by maternal IgG antibodies. Fetal or neonatal hemolysis is HDFN's primary pathological process resulting in anemia and neonatal jaundice. This review summarized recent progress in the pathophysiology of HDFN, the clinical correlation between anti-erythrocyte alloantibodies and HDFN, laboratory tests for alloimmunization in pregnancy, clinical evaluation of high-risk cases of HDFN, and treatment and prevention of HDFN at home and abroad.
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Objective To evaluate the clinical effects of ultrasonography for structural examination in the diagnosis of fetal brain malformation and neural tube defects ( NTDs ) in early pregnancy . Methods A retrospective study was conducted to analyse 6 630 cases taking obstetric examination in Dongguan Maternal and Child Health Hospital from February 2014 to June 2015. The examination included a standardized ultrasound structural examination at 11-13 plus 6 weeks of pregnancy. The autopsied results of the induced fetus in early pregnancy from craniocerebral and neural tube structure malformation were investigated. All the cases were followed up concerning the outcomes and the malformation detection rate was calculated for analysis. Results The detection rates of exencephalus and anencephalus, holoprosencephaly, aphylly-holoprosencephaly, rachischisis, open spina bifida, and meningocele were 100%, 80%, 100%, 42.9%, 50% and 100%, respectively. The malformations which was missed in the early pregnancy but detected in the later gestational ages included:Dandy-Walker Syndrome, most of the non-open spina bifida, hypoplasia of the corpus callosum, foliaceous-holoprosencephaly and ventriculomegaly. Conclusions The structural examination using ultrasonography at early pregnancy is effective in the detection of severe open-neural tube defects. It′s worth generalizing in the cliical diagnosis but part of fetal malformations still need a further ultrasound examination in the mid-gestation or the later gestation.
RESUMEN
is able to provide pathologic data and achieve the efficacy equivalent to surgery.