Oral Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2023

Contemporary approaches to the diagnosis and management of fetal and neonatal alloimmune thrombocytopenia (FNAIT) (#17)

Stefan Kane 1
  1. The Royal Women's Hospital, Parkville, VIC, Australia

Fetal/Neonatal Alloimmune Thrombocytopenia (FNAIT) is a rare but potentially devastating condition that arises from maternal alloimmunisation against fetal platelet antigens. This talk will explore advances in the diagnosis and management of FNAIT - a condition in which timely and accurate intervention can significantly impact neonatal outcomes.

Over the years, FNAIT has garnered increasing attention due to its potential for severe fetal and neonatal complications, including intracranial haemorrhage and long-term neurodevelopmental issues. This presentation will provide a comprehensive overview of contemporary approaches to FNAIT, encompassing diagnostic modalities, risk stratification, and innovative therapeutic strategies.

Key topics to be covered include:

  1. Risk Assessment and Prediction: When should this rare condition be suspected in fetal life? How is risk stratified in women known to be alloimmunised?
  2. Advancements in Diagnostic Techniques: The tools potentially available for the accurate identification of FNAIT include non-invasive prenatal testing (NIPT), fetal genotyping, fetal blood sampling for platelet count, and maternal antibody screening. 

  3. Innovative Therapeutic Approaches: Key therapies to be covered include intrauterine platelet transfusions and maternal IVIG treatment, with an emphasis on their efficacy and safety. We will explore the potential for gene therapy and other novel interventions currently under investigation, such as FcRn blockers (nipocalimab).

  4. Multidisciplinary Care: FNAIT management necessitates collaboration among MFM obstetricians, haematologists, neonatologists, and transfusion medicine specialists. A multidisciplinary approach is essential to optimise care for both the mother and the neonate.

  5. Long-Term Follow-Up: The session will conclude with a discussion on the importance of long-term follow-up for neonates affected by FNAIT, emphasizing neurodevelopmental assessments and early intervention strategies.