If your pregnancy is at risk of fetal and neonatal alloimmune thrombocytopenia (FNAIT) or if diagnosis has been confirmed, you will require specialist care throughout pregnancy and birth.
As a rare disease affecting approximately one in 1,1000 pregnancies, not all doctors will have experience managing an FNAIT-affected pregnancy.
A maternal-fetal medicine (MFM) specialist will coordinate a multidisciplinary team to ensure the best possible care for you and your baby. As highly trained OB-GYNs, MFM specialists specialize in taking care of women with high-risk pregnancies.
What is FNAIT?
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a rare but serious condition that affects 0.1% of pregnancies in which a pregnant mother’s immune system produces antibodies against the platelets of her fetus. This occurs when a fetus inherits platelet antigens from the father that are not compatible with the mother, typically involving a protein called human platelet antigen (HPA). The mother’s immune system recognizes the fetal platelets as foreign, attacking and destroying them, leading to low platelet levels (thrombocytopenia) in the fetus or newborn.
How an MFM specialist can care for FNAIT-affected pregnancies
MFM specialists benefit from two to three additional years of education and training in all aspects of the management of high-risk pregnancies. If you have previously experienced a FNAIT-affected pregnancy, if you have a family history of FNAIT or if FNAIT has already been diagnosed, you will be referred to an MFM specialist. If your access to a specialist center is limited by distance, your MFM specialist will liaise with your treating OB-GYN.
Learn more about the FNAIT care team
During an FNAIT pregnancy, your MFM specialist will oversee your care in all areas. To do this, an MFM specialist may:
Monitor and manage your pregnancy. Maintaining the overall health of you and baby and managing any complications that arise. Making decisions on how to achieve the best outcomes.
Order specialized tests. Regular blood tests to monitor platelet levels in the fetus and regular fetal ultrasounds to check for bleeding or hemorrhage. Other testing can include fetal
Collaborate with other specialists. A hematologist and transfusion specialist will need to participate in planning medical interventions such as administering intravenous immunoglobulin (IVIG) and steroids.
Support you. Give explanations and advice where needed, to support and reassure you during your high-risk pregnancy.
During labor and delivery your baby will be closely monitored by your MFM specialist. They will also monitor your well-being, participate in urgent decision-making and ensure immediate, acute care is available for your newborn.
Who else is part of the care team?
As well as an MFM specialist, you will have a healthcare team working to support you in different prenatal and postnatal capacities. As well as a hematologist and a transfusion specialist, you will also rely on the expertise of a radiologist for ultrasound or MRI imaging, an infusion nurse if you need IVIG infusions during pregnancy.
During delivery, depending on whether you have a vaginal or cesarean birth, you will benefit from a multidisciplinary team including an anesthetist, an obstetrician and nurses. On hand, you will also have a transfusion specialist, neonatologist, pediatrician and neurologist to assess and treat your newborn affected by FNAIT.
