Fetal thrombocytopenia is a condition that exists when there are a low number of platelets in the fetal blood. Platelets are important because they allow blood to clot to prevent bleeding. If the platelet number is too low there can be spontaneous bleeding that could result in fetal compromise or other problems after birth.
The most common reason for fetal thrombocytopenia is an incompatibility between platelet antigens in the mother's blood and the baby's blood. This happens when the baby inherits certain types of blood antigens from the father that the mother does not have. The mother's system creates antibodies that attack the fetal platelets with these antigens. This leads to the destruction of the fetal platelets causing thrombocytopenia. Some other causes of fetal thrombocytopenia can include maternal viral infections, such as toxoplasmosis, rubella, cytomegalovirus, or parvovirus.
Fetal thrombocytopenia is most often diagnosed after a previous child has been born with signs and symptoms of a low platelet count. This can include bleeding spots (petichiae), bruising or spontaneous internal bleeding. Bleeding can occur anywhere in the fetal body, including in the brain which can lead to stroke or even death. The mother may have antiplatelet antibodies in her blood. Fetal thrombocytopenia is not usually diagnosed during routine prenatal care in a healthy mother. After an affected pregnancy, all future pregnancies need to be carefully monitored.
Once suspected, a small sample of fetal blood can be obtained from the umbilical vein to determine the fetal platelet count using ultrasound to guide and visualize the procedure. This procedure also carries a risk of pregnancy loss, infection, bleeding from the umbilical cord puncture site, or preterm labor. In some cases, fetal heart rate decelerations are observed during the procedure and emergency delivery is required. Because of this concern, this test is usually performed in a hospital setting. If both mother and fetus tolerate the procedure, they can generally go home within 24 hours.
Fetal thrombocytopenia is monitored with ultrasound examinations and treated prenatally in several ways. The treatment plan may include maternal corticosteroids, like prednisone, or include intravenous transfusions of immunoglobulin to the mother. Some fetuses require a platelet transfusion.
Newborns generally do well after birth. The newborn may require platelet transfusions until platelet levels are normal. The mother will need to be evaluated in future pregnancies for possible fetal thrombocytopenia.
Long-term outcomes for infants with ventriculomegaly are variable. The neurological condition of your newborn is dependent on the severity of the ventriculomegaly and the presence of associated abnormalities. Children born with ventriculomegaly may have mild conditions such as developmental delay to severe conditions such as cerebral palsy. Your pediatric neurologists and neurosurgeons should be able to provide some sense of the severity of neurological impairment.
The Center team will help care for you and your infant with ventriculomegaly. The Center will develop a comprehensive plan with all of the physicians and specialists involved in the care of you and your newborn.
When you contact The Fetal Center, you will be in touch with a dedicated coordinator who will walk you through the process step-by-step and help you to understand every aspect of your care.
The Fetal Center at Children's Memorial Hermann Hospital
UT Professional Building
6410 Fannin, Suite 210
Houston, Texas 77030
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Located within the Texas Medical Center, The Fetal Center is affiliated with McGovern Medical School at UTHealth Houston, UT Physicians and Children’s Memorial Hermann Hospital.