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

Journal of Perinatology volume 39, pages 920–926 (2019)Cite this article

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Abstract

Objective

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.

Study design

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.

Result

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%).

Conclusion

Thrombocytopenia is common and underappreciated in fetuses undergoing PUBS for alloimmunization.

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Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01: HD 06161619-01A1, PI Cahill). Additionally supported by the National Institutes of Health [grant numbers UL1 TR000448 and P30 CA091842].

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA

    Joshua I. Rosenbloom, Ann M. Bruno, Shayna N. Conner, Methodius G. Tuuli, George A. Macones & Alison G. Cahill

  2. Bernard Becker Medical Library, Washington University School of Medicine in St. Louis, St. Louis, MO, USA

    Laura E. Simon

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  1. Joshua I. Rosenbloom
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  2. Ann M. Bruno
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  3. Shayna N. Conner
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  4. Methodius G. Tuuli
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  6. George A. Macones
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Correspondence to Joshua I. Rosenbloom.

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Rosenbloom, J.I., Bruno, A.M., Conner, S.N. et al. Fetal thrombocytopenia in pregnancies complicated by fetal anemia due to red-cell alloimmunization: cohort study and meta-analysis. J Perinatol 39, 920–926 (2019). https://doi.org/10.1038/s41372-019-0388-8

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