Original Article
Fetal Thrombocytopenia and Its Relation to Maternal Thrombocytopenia
N Engl J Med 1993; 329:1463-1466November 11, 1993
- Abstract
Background
Neonates with severe thrombocytopenia can have bleeding leading to death or lifelong residual defects. The predictors, frequency, and consequences of fetal thrombocytopenia are not known, nor is it known if there are maternal clinical features that could predict fetal thrombocytopenia.
Methods
We conducted a seven-year cross-sectional study in which platelet counts were determined in newborns' umbilical-cord blood and blood obtained from their mothers at consecutive deliveries in one obstetrical unit. The relations of the umbilical-cord platelet count to maternal risk factors were determined.
Results
Platelet counts were determined in blood samples from 15,471 mothers and 15,932 newborn infants. The cord-blood platelet count was less than 50,000 per cubic millimeter in 19 infants (0.12 percent; 95 percent confidence interval, 0.07 to 0.19 percent), whereas the platelet count was less than 150,000 per cubic millimeter in 6.6 percent of the mothers (95 percent confidence interval, 6.2 to 7.0 percent). One infant among those born to 756 mothers with incidental thrombocytopenia, 5 infants among those born to 1414 mothers with hypertension, and 4 infants among those born to 46 mothers with idiopathic thrombocytopenic purpura had cord-blood platelet counts between 20,000 and 50,000 per cubic millimeter. Only 6 infants (0.04 percent; 95 percent confidence interval, 0.01 to 0.08 percent) had cord-blood platelet counts of less than 20,000 per cubic millimeter; all their mothers were among the 18 whose 19 fetuses were at risk for neonatal alloimmune thrombocytopenia. Two of these infants had in utero intracranial hemorrhage. In addition, 3 infants born to these 18 women had cord-blood platelet counts between 20,000 and 50,000 per cubic millimeter; there was 1 stillbirth due to intracranial hemorrhage.
Conclusions
Moderate-to-severe fetal thrombocytopenia is a rare event. The only severely affected neonates with morbidity or mortality due to this condition are those born to mothers with antiplatelet alloantibodies.
Media in This Article
Table 1
Incidence of Fetal or Neonatal Thrombocytopenia, According to the Mother's Health Status and Platelet Count.Article Activity
- Article
Severe thrombocytopenia in an otherwise healthy neonate is an uncommon but important clinical finding1-3. Some infants with this condition have major bleeding, including intracranial hemorrhage, that may leave them with lifelong residual defects. Physicians have become highly aware of the risk of neonatal thrombocytopenia, and some have adopted an aggressive approach to treating the fetus with this potential problem. The issue is confounded by the fact that whereas severe thrombocytopenia is common among sick, premature infants (it occurs in as many as 15 percent of infants in a neonatal intensive care unit4,5), the frequency of thrombocytopenia at birth, as indicated by the cord-blood platelet count, among otherwise healthy infants is not known. We therefore studied the risks associated with moderate fetal thrombocytopenia (platelet count, 20,000 to 50,000 per cubic millimeter) and severe fetal thrombocytopenia (platelet count, <20,000 per cubic millimeter) among the infants born to a prospectively studied cohort of women at a tertiary care obstetrical unit. We also examined a number of potential risk factors in the mothers to determine whether they predicted which newborns would have thrombocytopenia.
Methods
We conducted a prospective surveillance study of all women admitted to our obstetrical unit, which is situated in a tertiary care hospital serving a largely white, middle-class population of approximately 1 million, from January 1986 through December 1992. On admission to the labor floor, all women had a complete blood count, including a platelet count. The mother was considered to have a normal hemostatic system if she did not have a history of thrombocytopenia, a bleeding disorder, or an underlying hypertensive or immunologic disorder. Women who had preterm deliveries (defined as those occurring at less than 37 weeks of gestation), multiple fetuses, and gestational and insulin-dependent diabetes mellitus were included in this group if they were otherwise normal. Women who were considered to have a higher-than-normal risk of hemostatic impairment were classified separately into a group with the hypertensive disorders of pregnancy and a group with the immune disorders idiopathic thrombocytopenic purpura and systemic lupus erythematosus. Women were considered to have idiopathic thrombocytopenic purpura if other causes of thrombocytopenia were excluded. All these women had chronic thrombocytopenia, and many had been treated with corticosteroids or intravenous immune globulin. Many also had platelet-survival tests performed to confirm that the thrombocytopenia was destructive in nature. The diagnosis of systemic lupus erythematosus was made according to the standard criteria of the American Rheumatism Association6. Women with hypertension and multiple fetuses or diabetes were included in the group with hypertensive disorders.
All newborn infants had a cord-blood platelet count performed. In some of these infants, a platelet count was not obtained for technical reasons (for example, the cord-blood sample clotted before anticoagulation), in which case one of the investigators reviewed the chart to ensure that the infant did not have a hemostatic defect. Because the study was conducted as an anonymous survey of samples collected for routine hematologic and obstetrical monitoring, the approval of the hospital ethics committee was not required.
Platelet counts were performed in blood samples collected in tubes containing EDTA with use of a Coulter counter (Coulter Electronics, Hialeah, Fla.). Thrombocytopenia was confirmed by examination of the peripheral-blood film to exclude the possibility that platelet clumping had caused an erroneous diagnosis of thrombocytopenia to be made by the electronic counter (pseudothrombocytopenia).
Maternal thrombocytopenia was considered to be present if the platelet count was less than or equal to 150,000 per cubic millimeter. For purposes of risk assessment, only cord-blood platelet counts less than or equal to 50,000 per cubic millimeter were reported. Infants whose platelet counts were below 50,000 per cubic millimeter underwent ultrasonography to identify any intracranial hemorrhages. Confidence intervals were calculated on the basis of a binomial distribution.
Results
During the seven-year study period, there were 15,663 deliveries in our obstetrical unit. Fifty-six women (0.4 percent) gave birth before or immediately after their arrival at the hospital, and a platelet count was therefore not performed antenatally; these women are not included in our analyses. Platelet counts were performed in blood samples obtained before delivery from the remaining 15,607 women, who delivered 16,068 infants. There were no multiple births in which cord-blood platelet counts were below 50,000 per cubic millimeter. There were 136 stillbirths of singleton infants, giving a total of 15,471 pregnancies available for analysis. Cord-blood platelet counts were obtained for 93.8 percent of the infants born to mothers in the “at-risk” categories (those with incidental thrombocytopenia, hypertension of pregnancy, or a history of idiopathic thrombocytopenic purpura). Platelet counts were obtained for cord-blood samples from an estimated 85 percent of the infants of low-risk mothers, who had normal platelet counts, were healthy, and did not have any evidence of hemostatic impairment. We assumed that infants without cord-blood samples whose neonatal course was uneventful had a cord-blood platelet count above 50,000 per cubic millimeter. Overall, cord-blood platelet counts were determined for 15,932 infants.
Nineteen infants had cord-blood platelet counts below 50,000 per cubic millimeter, giving an overall prevalence of 0.12 percent (95 percent confidence interval, 0.07 to 0.19 percent) (Table 1Table 1
Incidence of Fetal or Neonatal Thrombocytopenia, According to the Mother's Health Status and Platelet Count.). Six infants (0.4 percent; 95 percent confidence interval, 0.01 to 0.08 percent) had fewer than 20,000 platelets per cubic millimeter. Ten of the 19 infants with thrombocytopenia were born to mothers who had thrombocytopenia, and 9 were born to mothers who had normal platelet counts.We examined whether any clinical characteristics of the mothers could predict moderate or severe neonatal thrombocytopenia. A total of 1027 mothers had 150,000 or fewer platelets per cubic millimeter at delivery; the incidence of maternal thrombocytopenia was thus 6.6 percent (95 percent confidence interval, 6.2 to 7.0 percent). Severe maternal thrombocytopenia (platelet count, <100,000 per cubic millimeter) occurred in 181 women (1.2 percent; 95 percent confidence interval, 1.0 to 1.4 percent). Only 3 of the 19 infants with platelet counts below 50,000 per cubic millimeter were born to mothers with such severe thrombocytopenia.
A total of 756 women (73.6 percent of those with thrombocytopenia) had incidental thrombocytopenia of pregnancy (Table 1). Cord-blood samples were obtained from 761 of the infants born to these women (94.2 percent of the total), one of whom had thrombocytopenia (platelet count, 44,000 per cubic millimeter). This infant, who was delivered vaginally, had trisomy 21 and was given a diagnosis of congenital marrow dysfunction. Neonatal cranial ultrasonography did not demonstrate an intracranial hemorrhage.
Among the women with thrombocytopenia, 216 (21.0 percent) had a hypertensive disorder of pregnancy (Table 1). Cord-blood samples were obtained from 226 of their infants (93.8 percent), of whom 4 had thrombocytopenia (platelet counts, 34,000, 36,000, 38,000, and 44,000 per cubic millimeter). A total of 1414 women with hypertension delivered 1495 infants. Of the 1198 hypertensive women without thrombocytopenia, 1 delivered an infant who had a cord-blood platelet count of 40,000 per cubic millimeter. All five of the infants with thrombocytopenia born to hypertensive mothers were delivered before term by cesarean section. One infant had a trisomy 13 and died. Three of the remaining infants had birth weights below the 10th percentile for gestational age, and two of these infants had evidence of intracranial hemorrhage on neonatal ultrasonography. One infant's weight was appropriate for gestational age and there were no sequelae of the thrombocytopenia.
Thirty-nine of the women with thrombocytopenia (3.8 percent) had an immunologic disorder complicating pregnancy; 31 women had idiopathic thrombocytopenic purpura, and 8 women had systemic lupus erythematosus (Table 1). None of the eight infants born to mothers with systemic lupus erythematosus had a cord-blood platelet count below 50,000 per cubic millimeter. Two of the infants born to the 31 mothers with a history of idiopathic thrombocytopenic purpura who had thrombocytopenia at delivery had cord-blood platelet counts of 21,000 and 28,000 per cubic millimeter. During the study, 46 women with idiopathic thrombocytopenic purpura delivered their infants in our institution. Two of the 15 infants born to mothers with idiopathic thrombocytopenic purpura who did not have thrombocytopenia had cord-blood platelet counts of 36,000 and 49,000 per cubic millimeter. Of the four infants of mothers with idiopathic thrombocytopenic purpura who had cord-blood platelet counts of 20,000 to 50,000 per cubic millimeter, three were delivered vaginally and one was delivered by cesarean section for an obstetrical indication. No infant had an adverse outcome, and ultrasonographic examination of the infants with moderate or severe thrombocytopenia revealed no evidence of intracranial hemorrhage.
In 19 pregnancies in 18 women there was a potential for alloimmune neonatal thrombocytopenia. All had maternal-paternal platelet alloantigen discrepancy according to radioimmunoprecipitation analysis, 15 had previously had affected infants, and 3 were sisters of women with alloimmune thrombocytopenia. Three infants with cord-blood platelet counts from 20,000 to 50,000 per cubic millimeter and six infants with counts below 20,000 per cubic millimeter were born to these 18 women (platelet counts, 6,000, 8,000, 9,000, 11,000, 11,000, 13,000, 30,000, 34,000 and 40,000 per cubic millimeter) (Table 1). A 10th infant was stillborn at 35 weeks of gestation, having died of an intracranial hemorrhage confirmed at autopsy. Two of the severely affected live-born infants were first identified on routine ultrasonography as having had in utero intracranial hemorrhage. There were no new neonatal intracranial events identified by neonatal ultrasonography in the nine infants with severe thrombocytopenia due to alloimmunization. Three mothers carrying infants with potential alloimmune thrombocytopenia themselves had thrombocytopenia (platelet counts at delivery, 86,000, 120,000, and 139,000 per cubic millimeter) (Table 1). All three of their infants had cord-blood platelet counts below 20,000 per cubic millimeter (8,000, 9,000, and 11,000 per cubic millimeter). These mothers had both incidental thrombocytopenia of pregnancy and alloimmune thrombocytopenia.
Discussion
Thrombocytopenia in newborn infants, like that in adults, can be caused by underproduction, increased destruction, and sequestration of platelets within an enlarged spleen. Most infants in whom thrombocytopenia develops are ill, are premature, and have other disorders that could contribute to the thrombocytopenia, including disseminated intravascular coagulation and bacteremia. In these sick infants, the frequency of thrombocytopenia is as high as 15 percent, and it is most severe several days after delivery4,5. Thrombocytopenia can also be present at birth. Usually, the thrombocytopenia is caused by maternal factors such as antiplatelet alloantibodies or autoantibodies that have crossed the placenta1-3. Concern about the optimal care of these infants has prompted a variety of maneuvers, but there has been little attention to the frequency of thrombocytopenia among otherwise healthy infants and to whether these infants who will have thrombocytopenia can be identified by a maternal characteristic or associated illnesses.
During a seven-year period, we prospectively studied more than 15,000 women and their infants. We previously described the frequency of maternal thrombocytopenia in some of these women7-10; the main causes of thrombocytopenia were incidental thrombocytopenia of pregnancy (74 percent), hypertensive diseases of pregnancy (21 percent), and immune thrombocytopenic disorders of pregnancy (idiopathic thrombocytopenic purpura and systemic lupus erythematosus) (4 percent). In the current study, our focus was on fetal thrombocytopenia identified by cord-blood sampling. We found that moderate thrombocytopenia (cord-blood platelet count, 20,000 to 50,000 per cubic millimeter) or severe thrombocytopenia (<20,000 per cubic millimeter) is a distinctly uncommon event, occurring in fewer than 0.2 percent of all infants delivered in our institution.
The disorders that cause thrombocytopenia in mothers -- such as incidental thrombocytopenia, idiopathic thrombocytopenic purpura, systemic lupus erythematosus, and the hypertensive disorders of pregnancy -- usually did not cause moderate-to-severe fetal or neonatal thrombocytopenia in their infants. The one group of infants at very high risk were those whose mothers had alloimmune antiplatelet antibodies. These mothers had the infants with the most severe thrombocytopenia; all infants whose cord-blood platelet count was below 20,000 per cubic millimeter were born to the women in this group. Indeed, it was this group that accounted for all fetal morbidity and mortality.
There were three adverse outcomes, all of which were related to bleeding. All three infants had serologically confirmed alloimmune thrombocytopenia. One death occurred in 1987 in utero before aggressive intravenous immune globulin therapy was routinely used. Two infants had intracranial hemorrhages unexpectedly discovered on routine ultrasonography during apparently uncomplicated pregnancies (an occurrence that may reflect the high rate of use of ultrasonography in low-risk obstetrics in Canada). Others have also described antenatal morbidity and mortality in alloimmunized infants11. These two infants were the only ones with alloimmune thrombocytopenia in this study who were not identified by family history (alloimmune thrombocytopenia in either the mother or the mother's sister).
The apparent coincidence that three of the infants with the most severe thrombocytopenia were born to mothers who also had incidental thrombocytopenia of pregnancy is noteworthy. Before delivery, the infants of all three women were known to be at risk for neonatal alloimmune thrombocytopenia caused by platelet-specific alloantibody PLA1 (HPA-1a). Had these women's true status not been known, they might inappropriately have been considered to have idiopathic thrombocytopenic purpura in pregnancy, and a much more severe outcome would have been attributed to the idiopathic thrombocytopenic purpura than actually occurred. Perhaps the association of alloimmune neonatal thrombocytopenia and incidental thrombocytopenia of pregnancy explains some of the reports of severely affected infants born to mothers with mild idiopathic thrombocytopenic purpura.
The incidence of alloimmunization in our infants at term was approximately 1 per 5000 live births. This is in agreement with the results of several retrospective studies12,13 in which the reported incidence ranged from 1 per 5000 to 1 per 10,000 and the one prospective study14 in which a range of values from 1 per 2000 to 1 per 3000 live births was estimated. The incidence of alloimmunization in our study could be an underestimate, since we included only women identified by their infants' cord-blood platelet count of less than 50,000 per cubic millimeter. A more inclusive and comprehensive evaluation of all cord-blood platelet counts below 150,000 per cubic millimeter might have identified more cases of lesser severity.
In most recent studies of idiopathic thrombocytopenic purpura in pregnancy,15-18 severe fetal thrombocytopenia (in utero) was distinctly uncommon. These studies also indicated that although neonatal morbidity and mortality can occur, some bleeding problems can be prevented with early recognition and therapeutic intervention. Our report provides the obstetrician and internist with population-based estimates of the risk of severe thrombocytopenia in the fetuses and neonates of women with various thrombocytopenic disorders. So long as an obstetrical unit does not serve a population in which there is a high prevalence of unique conditions associated with maternal and possibly infant thrombocytopenia -- such as human immunodeficiency virus infection -- our results should be generalizable to most populations.
The importance of maternal anti-HLA class I antibodies against paternal platelets as a cause of neonatal thrombocytopenia has been debated. In some studies, these antibodies were associated with severe thrombocytopenia, but other investigators have suggested that the optimal techniques to detect platelet-specific alloantibodies were not always used in those studies. We did not address this issue specifically. However, on the basis of one study,19 it can be estimated that 4 to 25 percent of women (depending on parity) form anti-HLA alloantibodies to paternal platelets. Only one of the women we studied had only an anti-HLA alloantibody detected, and her infant did not have a platelet count below 50,000 per cubic millimeter. These observations suggest that anti-HLA alloantibodies are not a common cause of severe neonatal thrombocytopenia.
Moderate-to-severe neonatal thrombocytopenia does occur, but it is uncommon. In our study severe thrombocytopenia was seldom associated with idiopathic thrombocytopenic purpura, incidental thrombocytopenia of pregnancy, or the hypertensive disorders of pregnancy, but it was associated with platelet alloimmunization. These results should not be interpreted to indicate that severe thrombocytopenia can never occur in the infants of mothers who have idiopathic thrombocytopenic purpura or systemic lupus erythematosus. Moreover, the platelet count typically falls after delivery,20 and consequently, infants born to mothers with idiopathic thrombocytopenic purpura and other conditions that place the infant at risk for thrombocytopenia in the peripartum period should be followed carefully to ensure that the platelet count does not fall to dangerous levels.
Supported by the Medical Research Council of Canada.
Source Information
From the Departments of Obstetrics and Gynecology, Medicine, and Pathology, McMaster University Medical Centre, and the Canadian Red Cross Blood Transfusion Service Hamilton Centre, Hamilton, Ont.
Address reprint requests to Dr. Burrows at the Department of Obstetrics and Gynecology, McMaster University Medical Centre, 1200 Main St. W., Hamilton, ON L8N 3Z5, Canada.
- References
References
1
McCrae KR ,Samuels P ,Schreiber AD . Pregnancy-associated thrombocytopenia: pathogenesis and management. Blood 1992;80:2697-2714
Web of Science | Medline2
Cines DB . Idiopathic thrombocytopenic purpura complicating pregnancy. Med Grand Rounds 1984;3:344-3533
Bussel JB, Schreiber AD. Immune thrombocytopenic purpura, neonatal alloimmune thrombocytopenia and post-transfusion purpura. In: Hoffman R, Benz EJ, Shattil SJ, Furie B, Cohen HJ, eds. Hematology: basic principles and practice. New York: Churchill Livingstone, 1991:1485-94.
4
Bleeding disorders in the newborn infant. In: Hathaway WE, Bonnar J. Perinatal coagulation. New York: Grune & Stratton, 1978:115-69.
5
Andrew M ,Castle V ,Saigal S ,Carter C ,Kelton JG . Clinical impact of neonatal thrombocytopenia. J Pediatr 1987;110:457-464
CrossRef | Web of Science | Medline6
Tan EM ,Cohen AS ,Fries JF , et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982;25:1271-1277
CrossRef | Web of Science | Medline7
Burrows RF ,Kelton JG . Incidentally detected thrombocytopenia in healthy mothers and their infants. N Engl J Med 1988;319:142-145
Full Text | Web of Science | Medline8
Burrows RF ,Kelton JG . Thrombocytopenia at delivery: a prospective survey of 6715 deliveries. Am J Obstet Gynecol 1990;162:731-734
Web of Science | Medline9
Burrows RF ,Andrew M . Neonatal thrombocytopenia in the hypertensive disorders of pregnancy. Obstet Gynecol 1990;76:234-238
Web of Science | Medline10
Burrows RF ,Kelton JG . Low fetal risks in pregnancies associated with idiopathic thrombocytopenic purpura. Am J Obstet Gynecol 1990;163:1147-1150
Web of Science | Medline11
Mueller-Eckhardt C ,Kiefel V ,Grubert A , et al. 348 Cases of suspected neonatal alloimmune thrombocytopenia. Lancet 1989;1:363-366
CrossRef | Web of Science | Medline12
Pearson HA ,Shulman NR ,Marder VJ ,Cone TE . Isoimmune neonatal thrombocytopenic purpura: clinical and therapeutic considerations. Blood 1964;23:154-177
Web of Science | Medline13
Shulman NR ,Marder VJ ,Hiller MC ,Collier EM . Platelet and leukocyte isoantigens and their antibodies: serologic, physiologic and clinical studies. Prog Hematol 1964;4:222-304
Medline14
Blanchette VS . Neonatal alloimmune thrombocytopenia: a clinical perspective. Curr Stud Hematol Blood Transfus 1988;54:112-126
Medline15
Cook RL ,Miller RC ,Katz VL ,Cefalo RC . Immune thrombocytopenic purpura in pregnancy: a reappraisal of management. Obstet Gynecol 1991;78:578-583
Web of Science | Medline16
Samuels P ,Bussel JB ,Braitman LE , et al. Estimation of the risk of thrombocytopenia in the offspring of pregnant women with presumed immune thrombocytopenic purpura. N Engl J Med 1990;323:229-235
Full Text | Web of Science | Medline17
Moutet A ,Fromont P ,Farcet J-P , et al. Pregnancy in women with immune thrombocytopenic purpura. Arch Intern Med 1990;150:2141-2145
CrossRef | Web of Science | Medline18
Christiaens GCML ,Nieuwenhuis HK , von dem Borne AEGKr, et al. Idiopathic thrombocytopenic purpura in pregnancy: a randomized trial on the effect of antenatal low dose corticosteroids on neonatal platelet count. Br J Obstet Gynaecol 1990;97:893-898
CrossRef | Medline19
Taaning E ,Skibsted L . The frequency of platelet alloantibodies in pregnant women and the occurrence and management of neonatal alloimmune thrombocytopenic purpura. Obstet Gynecol Surv 1990;45:521-525
CrossRef | Medline20
Kelton JG . Management of the pregnant patient with idiopathic thrombocytopenic purpura. Ann Intern Med 1983;99:796-800
Web of Science | Medline
- Citing Articles (128)
Citing Articles
1
Robert M. Silver. 2012. Thrombocytopenia. , 102-107.
CrossRef2
Graziela Carvalheiras, Raquel Faria, Jorge Braga, Carlos Vasconcelos. (2011) Fetal outcome in autoimmune diseases. Autoimmunity Reviews
CrossRef3
Tamam Bakchoul, Sebastian Kubiak, Annika Krautwurst, Monika Roderfeld, Hans C. Siebert, Gregor Bein, Ulrich J. Sachs, Sentot Santoso. (2011) Low-avidity anti-HPA-1a alloantibodies are capable of antigen-positive platelet destruction in the NOD/SCID mouse model of alloimmune thrombocytopenia. Transfusion 51:11, 2455-2461
CrossRef4
Michael Egbor, Peter Knott, Amarnath Bhide. (2011) Red-cell and platelet alloimmunisation in pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology
CrossRef5
Nadine Shehata, Gregory A. Denomme, Barbara Hannach, Nancy Banning, John Freedman. (2011) Mass-scale high-throughput multiplex polymerase chain reaction for human platelet antigen single-nucleotide polymorphisms screening of apheresis platelet donors. Transfusion 51:9, 2028-2033
CrossRef6
Subarna Chakravorty, Irene Roberts. (2011) How I manage neonatal thrombocytopenia. British Journal of Haematologyno-no
CrossRef7
Zoe K. MCQUILTEN, Erica M. WOOD, Helen SAVOIA, Stephen COLE. (2011) A review of pathophysiology and current treatment for neonatal alloimmune thrombocytopenia (NAIT) and introducing the Australian NAIT registry. Australian and New Zealand Journal of Obstetrics and Gynaecology 51:3, 191-198
CrossRef8
Jan E. Dickinson. (2011) Fetomaternal alloimmune thrombocytopenia: Increasing awareness. Australian and New Zealand Journal of Obstetrics and Gynaecology 51:3, 189-190
CrossRef9
Rachel Rayment, Susan J Brunskill, Peter W Soothill, David J Roberts, James B Bussel, Michael F Murphy, Rachel Rayment. 2011. Antenatal interventions for fetomaternal alloimmune thrombocytopenia. .
CrossRef10
Paula L. Bockenstedt. (2011) Thrombocytopenia in Pregnancy. Hematology/Oncology Clinics of North America 25:2, 293-310
CrossRef11
Yaakov Beilin. (2011) Thrombocytopenia and Low Molecular Weight Heparin in the Parturient. ASA Refresher Courses in Anesthesiology 39:1, 6-12
CrossRef12
Tae-Jung Sung. (2011) Disorders in Hemostasis. Journal of the Korean Society of Neonatology 18:1, 14
CrossRef13
Carl A. Laskin, Karen A. Spitzer, Christine A. Clark. 2011. Pregnancy and Reproductive Concerns in Systemic Lupus Erythematosus. , 655-672.
CrossRef14
Michael J. Paidas, Nazli Hossain. 2010. Maternal and Fetal Thrombocytopenia. , 41-66.
CrossRef15
Michael J. Paidas, Nazli Hossain. 2010. Hematologic Changes in Pregnancy. , 1-11.
CrossRef16
Bjørn Skogen, Mette Kjær Killie, Jens Kjeldsen-Kragh, Maria Therese Ahlen, Heidi Tiller, Tor B Stuge, Anne Husebekk. (2010) Reconsidering fetal and neonatal alloimmune thrombocytopenia with a focus on screening and prevention. Expert Review of Hematology 3:5, 559-566
CrossRef17
MM Kamphuis, N Paridaans, L Porcelijn, M De Haas, CE van der Schoot, A Brand, GJ Bonsel, D Oepkes. (2010) Screening in pregnancy for fetal or neonatal alloimmune thrombocytopenia: systematic review. BJOG: An International Journal of Obstetrics & Gynaecology 117:11, 1335-1343
CrossRef18
Sreedhar Gaddipati, Richard L. Berkowitz. 2010. Isoimmune Thrombocytopenia. , 165-170.
CrossRef19
Claire McLintock, John T. Repke, Brenda Bucklin. 2010. Hematologic Disease in Pregnancy. , 48-81.
CrossRef20
Ayala Maayan-Metzger, Lea Leibovitch, Irit Schushan-Eisen, Tzipora Strauss, Gili Kenet, Jacob Kuint. (2010) Predictors for neonatal thrombocytopenia in infants of thrombocytopenic mothers during pregnancy. Pediatric Blood & Cancern/a-n/a
CrossRef21
H Özkan, M Çetinkaya, N Köksal, R Ali, A M Güneş, B Baytan, F Özkalemkaş, V Özkocaman, T Özçelik, Ü Günay, A Tunali, Y Kimya, C Cengiz. (2010) Neonatal outcomes of pregnancy complicated by idiopathic thrombocytopenic purpura. Journal of Perinatology 30:1, 38-44
CrossRef22
Evi Stavrou, Keith R. McCrae. (2009) Immune Thrombocytopenia in Pregnancy. Hematology/Oncology Clinics of North America 23:6, 1299-1316
CrossRef23
Bethan Myers. (2009) Thrombocytopenia in pregnancy. The Obstetrician & Gynaecologist 11:3, 177-183
CrossRef24
J. BUSSEL. (2009) Diagnosis and management of the fetus and neonate with alloimmune thrombocytopenia. Journal of Thrombosis and Haemostasis 7, 253-257
CrossRef25
Hyung Seok Yoo, Sung Wook Park, Jin Hee Han, Jun Young Chung, Jae Woo Yi, Jong Man Kang, Bong Jae Lee, Dong Ok Kim. (2009) Paraplegia Caused by an Epidural Hematoma in a Patient With Unrecognized Chronic Idiopathic Thrombocytopenic Purpura Following an Epidural Steroid Injection. Spine 34:10, E376-E379
CrossRef26
James B. Bussel, Martha Sola-Visner. (2009) Current Approaches to the Evaluation and Management of the Fetus and Neonate with Immune Thrombocytopenia. Seminars in Perinatology 33:1, 35-42
CrossRef27
Minehiro Kurai, Masamune Higashigawa, Noriko Yodoya, Yukako Kawasaki, Yuji Nashida, Yoshio Amemiya, Takashi Fujiwara, Masakazu Inoue. (2009) A Case of Neonatal Alloimmune Thrombocytopenia Associated with anti-HPA-4b Antibody in an Infant Delivered from a Mother with Gestational Thrombocytopenia. Journal of Nihon University Medical Association 68:1, 21-24
CrossRef28
O. Pourrat, F. Pierre. (2008) Que faire en pratique à la découverte d’une thrombopénie en cours de grossesse ?. La Revue de Médecine Interne 29:10, 808-814
CrossRef29
Donald M. Arnold, James W. Smith, John G. Kelton. (2008) Diagnosis and Management of Neonatal Alloimmune Thrombocytopenia. Transfusion Medicine Reviews 22:4, 255-267
CrossRef30
B. Zhou, S. Saito, Y. Nakazawa, N. Kobayashi, M. Matsuda, Y. Matsumoto, T. Hosoyama, K. Koike. (2008) Existence of an immunoglobulin G component of naturally occurring HLA class I antibodies that are not directed against self-antigens in human serum. Tissue Antigens 72:2, 98-104
CrossRef31
Irene Roberts, Neil A. Murray. (2008) Neonatal thrombocytopenia. Seminars in Fetal and Neonatal Medicine 13:4, 256-264
CrossRef32
Cedric Ghevaert, David A. Wilcox, Juan Fang, Kathryn L. Armour, Mike R. Clark, Willem H. Ouwehand, Lorna M. Williamson. (2008) Developing recombinant HPA-1a–specific antibodies with abrogated Fcγ receptor binding for the treatment of fetomaternal alloimmune thrombocytopenia. Journal of Clinical Investigation
CrossRef33
Irene Roberts, Simon Stanworth, Neil A Murray. (2008) Thrombocytopenia in the Neonate. Blood Reviews 22:4, 173-186
CrossRef34
R Sukenik-Halevy, M H. Ellis, M D. Fejgin. (2008) Management of Immune Thrombocytopenic Purpura in Pregnancy. Obstetrical & Gynecological Survey 63:3, 182-188
CrossRef35
Eline S.A. van den Akker, Dick Oepkes. (2008) Fetal and neonatal alloimmune thrombocytopenia. Best Practice & Research Clinical Obstetrics & Gynaecology 22:1, 3-14
CrossRef36
James B. Bussel, Andrea Primiani. (2008) Fetal and neonatal alloimmune thrombocytopenia: progress and ongoing debates. Blood Reviews 22:1, 33-52
CrossRef37
Michael F. Murphy, Lorna M. Williamson. (2008) Antenatal screening for fetomaternal alloimmune thrombocytopenia: an evaluation using the criteria of the uk national screening committee. British Journal of Haematology 111:3, 726
CrossRef38
G. A. Smith, A. Rankin, C. Riddle, C. Cheetham-Wilkinson, E. Ranasinghe, W. H. Ouwehand, N. A. Watkins. (2007) Severe fetomaternal alloimmune thrombocytopenia due to anti-human platelet antigen (HPA)-1a in a mother with a rare and silenced ITGB3*0101 (GPIIIa) allele. Vox Sanguinis 93:4, 325-330
CrossRef39
Donald M. Arnold, John G. Kelton. (2007) Current Options for the Treatment of Idiopathic Thrombocytopenic Purpura. Seminars in Hematology 44, S12-S23
CrossRef40
Dirk Bassler, Andreas Greinacher, Chusak Okascharoen, Anne Klenner, Juliana Ditomasso, Volker Kiefel, Anthony Chan, Bosco Paes. (2007) A systematic review and survey of the management of unexpected neonatal alloimmune thrombocytopenia. Transfusion 0:0, 071003012013005-???
CrossRef41
Terry Gernsheimer, Keith R McCrae. (2007) Immune thrombocytopenic purpura in pregnancy. Current Opinion in Hematology 14:5, 574-580
CrossRef42
E. Muñiz-Diaz. (2007) Diagnostic evaluation of FNAIT. ISBT Science Series 2:1, 48-55
CrossRef43
Cedric Ghevaert, Kate Campbell, Prachi Stafford, Paul Metcalfe, Angela Casbard, Graham A. Smith, Dave Allen, Edmund Ranasinghe, Lorna M. Williamson, Willem H. Ouwehand. (2007) HPA-1a antibody potency and bioactivity do not predict severity of fetomaternal alloimmune thrombocytopenia. Transfusion 47:7, 1296-1305
CrossRef44
T FELBINGER, M POSNER, H ELTZSCHIG, B KODALI. (2007) Laparoscopic splenectomy in a pregnant patient with immune thrombocytopenic purpura. International Journal of Obstetric Anesthesia 16:3, 281-283
CrossRef45
MK Killie, J Kjeldsen-Kragh, A Husebekk, B Skogen, JA Olsen, IS Kristiansen. (2007) Cost-effectiveness of antenatal screening for neonatal alloimmune thrombocytopenia. BJOG: An International Journal of Obstetrics & Gynaecology 114:5, 588-595
CrossRef46
Cedric Ghevaert, Kate Campbell, Jill Walton, Graham A. Smith, Dave Allen, Lorna M. Williamson, Willem H. Ouwehand, Edmund Ranasinghe. (2007) Management and outcome of 200 cases of fetomaternal alloimmune thrombocytopenia. Transfusion 47:5, 901-910
CrossRef47
Olivier Pourrat, Fabrice Pierre. (2007) Causes of thrombocytopenia in pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 132:1, 132
CrossRef48
Eyal Sheiner, Michal Parnas. (2007) Reply: Moderate to severe thrombocytopenia during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 132:1, 132-133
CrossRef49
Michael F. Murphy, James B. Bussel. (2007) Advances in the management of alloimmune thrombocytopenia. British Journal of Haematology 136:3, 366-378
CrossRef50
Stephanie Seremetis, Victoria Afshani. 2007. Management of Bleeding Disorders in Pregnancy. , 581-591.
CrossRef51
James N. George, Kiarash Kojouri. 2007. Immune Thrombocytopenic Purpura. , 123-138.
CrossRef52
Yoav Yinon, Maya Spira, Ofira Solomon, Boaz Weisz, Benjamin Chayen, Eyal Schiff, Shlomo Lipitz. (2006) Antenatal noninvasive treatment of patients at risk for alloimmune thrombocytopenia without a history of intracranial hemorrhage. American Journal of Obstetrics and Gynecology 195:4, 1153-1157
CrossRef53
Michal Parnas, Eyal Sheiner, Ilana Shoham-Vardi, Eliezer Burstein, Tikva Yermiahu, Itai Levi, Gershon Holcberg, Ronit Yerushalmi. (2006) Moderate to severe thrombocytopenia during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology 128:1-2, 163-168
CrossRef54
Dino Veneri, Massimo Franchini, Ricciarda Raffaelli, Mariella Musola, Alessia Memmo, Massimo Franchi, Giovanni Pizzolo. (2006) Idiopathic thrombocytopenic purpura in pregnancy: analysis of 43 consecutive cases followed at a single Italian institution. Annals of Hematology 85:8, 552-554
CrossRef55
Stefano Raffaele Giannubilo, Vissam Abu Shkara, Andrea Luigi Tranquilli. (2006) Effect of betametasone administration on platelet count in thrombocytopenic and normal pregnant women. Archives of Gynecology and Obstetrics 274:3, 130-132
CrossRef56
Cynthia Gyamfi, Keith A Eddleman. (2005) Alloimmune Thrombocytopenia. Clinical Obstetrics and Gynecology 48:4, 897-909
CrossRef57
Marc L. Turner, Hagop Bessos, Timothy Fagge, Mairi Harkness, Frances Rentoul, Janelle Seymour, David Wilson, Irene Gray, Ridheesh Ahya, John Cairns, Stan Urbaniak. (2005) Prospective epidemiologic study of the outcome and cost-effectiveness of antenatal screening to detect neonatal alloimmune thrombocytopenia due to anti-HPA-1a. Transfusion 45:12, 1945-1956
CrossRef58
V. M. L. Serrarens-Janssen, E. A. P. Steegers, A. Bos, A. F. J. Heijst, R. Rodrigues Pereira, B. A. Semmekrot. (2005) Meldingen van neonatale allo-immuuntrombocytopenie (naitp) in Nederland: resultaten van een inventarisatie via het Nederlands Signaleringscentrum Kindergeneeskunde. Tijdschrift voor kindergeneeskunde 73:6, 29-33
CrossRef59
M. Mandelbaum, D. Koren, B. Eichelberger, L. Auerbach, S. Panzer. (2005) Frequencies of maternal platelet alloantibodies and autoantibodies in suspected fetal/neonatal alloimmune thrombocytopenia, with emphasis on human platelet antigen-15 alloimmunization. Vox Sanguinis 89:1, 39-43
CrossRef60
Douglas B. Cines, Robert McMillan. (2005) Management of Adult Idiopathic Thrombocytopenic Purpura. Annual Review of Medicine 56:1, 425-442
CrossRef61
Rachel Rayment, Susan J Brunskill, Peter W Soothill, David J Roberts, James B Bussel, Michael F Murphy, Rachel Rayment. 2005. Antenatal interventions for fetomaternal alloimmune thrombocytopenia. .
CrossRef62
Stefan Kuhle, Lesley Mitchell, Patricia Massicotte, Maureen Andrew. 2005. Hemostatic Disorders of the Newborn. , 1145-1179.
CrossRef63
H. Ohto, S. Miura, H. Ariga, T. Ishii, K. Fujimori, S. Morita. (2004) The natural history of maternal immunization against foetal platelet alloantigens. Transfusion Medicine 14:6, 399-408
CrossRef64
Uma Raju, Punita Arora. (2004) Neonatal immune thrombocytopenia. Medical Journal Armed Forces India 60:4, 333-336
CrossRef65
Olivier Pourrat, André Brizard, Fabrice Pierre. (2004) Causes of thrombocytopenia in triplet pregnancies. American Journal of Obstetrics and Gynecology 190:6, 1797
CrossRef66
Huda B Al-Kouatly, Stephen T Chasen. (2004) Reply. American Journal of Obstetrics and Gynecology 190:6, 1797-1798
CrossRef67
Diana L. Cochran-Black, Marta L. Klein. (2004) case study [coagulation and hematology]: Easy Bruising and Epistaxis in a 30-Year-Old Pregnant Woman. Laboratory Medicine 35:6, 357-359
CrossRef68
R. Stasi, D. Provan. (2004) Management of Immune Thrombocytopenic Purpura in Adults. Mayo Clinic Proceedings 79:4, 504-522
CrossRef69
P. C. A. Kam, S. A. Thompson, A. C. S. Liew. (2004) Thrombocytopenia in the parturient. Anaesthesia 59:3, 255-264
CrossRef70
Satoshi Saito, Masao Ota, Yumi Komatsu, Satoshi Ota, Shigeru Aoki, Kenichi Koike, Izumi Tokunaga, Takahisa Tsuno, Goro Tsuruta, Tetsuo Kubo, Hirofumi Fukushima. (2003) Serologic analysis of three cases of neonatal alloimmune thrombocytopenia associated with HLA antibodies. Transfusion 43:7, 908-917
CrossRef71
Janet E. Birchall, Michael F. Murphy, Hartmut Kroll, . (2003) European collaborative study of the antenatal management of feto-maternal alloimmune thrombocytopenia. British Journal of Haematology 122:2, 275-288
CrossRef72
C. M. Radder, A. Brand, H. H. H. Kanhai. (2003) Will it ever be possible to balance the risk of intracranial haemorrhage in fetal or neonatal alloimmune thrombocytopenia against the risk of treatment strategies to prevent it?. Vox Sanguinis 84:4, 318-325
CrossRef73
Balraj S. Jhawar, Adrianna Ranger, David Steven, Rolando F. Del Maestro. (2003) Risk Factors for Intracranial Hemorrhage among Full-term Infants: A Case-Control Study. Neurosurgery581-590
CrossRef74
Keith R McCrae. (2003) Thrombocytopenia in pregnancy: differential diagnosis, pathogenesis, and management. Blood Reviews 17:1, 7-14
CrossRef75
(2003) Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy. British Journal of Haematology 120:4, 574-596
CrossRef76
M.F. Murphy, L.M. Williamson, S.J. Urbaniak. (2002) Antenatal Screening for Fetomaternal Alloimmune Thrombocytopenia: Should we be doing it?. Vox Sanguinis 83, 409-416
CrossRef77
Kingo Fujimura, Yuka Harada, Tetsuro Fujimoto, Atsushi Kuramoto, Yasuo Ikeda, Jun-ichi Akatsuka, Kazuo Dan, Mitsuhiro Omine, Hideaki Mizoguchi. (2002) Nationwide Study of Idiopathic Thrombocytopenic Purpura in Pregnant Women and the Clinical Influence on Neonates. International Journal of Hematology 75:4, 426-433
CrossRef78
Cines, Douglas B., Blanchette, Victor S., . (2002) Immune Thrombocytopenic Purpura. New England Journal of Medicine 346:13, 995-1008
Full Text79
J.G. Kelton. (2002) Idiopathic thrombocytopenic purpura complicating pregnancy. Blood Reviews 16:1, 43-46
CrossRef80
Richard K. Burt, Shimon Slavin, William H. Burns, Alberto M. Marmont. (2002) Induction of tolerance in autoimmune diseases by hematopoietic stem cell transplantation: Getting closer to a cure?. International Journal of Hematology 76:S1, 226-247
CrossRef81
Ivo Elezovic, Darinka Boskovic, Dragica Tomin, Z. Pilic, Zeljko Mikovic, M. Popovic, S. Knezevic, M. Sukalo. (2002) Cesarean section combined with splenectomy in severe resistant immune thrombocytopenia. Acta chirurgica iugoslavica 49:3, 51-54
CrossRef82
Martha C. Sola, Christof Dame, Robert D. Christensen. (2001) Toward a Rational Use of Recombinant Thrombopoietin in the Neonatal Intensive Care Unit. Journal of Pediatric Hematology/Oncology 23:3, 179-184
CrossRef83
Jillian A Spencer, Robert F Burrows. (2001) Fetomaternal alloimmune thrombocytopenia: a literature review and statistical analysis. The Australian and New Zealand Journal of Obstetrics and Gynaecology 41:1, 45-55
CrossRef84
Irene A.G. Roberts, Neil A. Murray. (2001) Neonatal thrombocytopenia: new insights into pathogenesis and implications for clinical management. Current Opinion in Pediatrics 13:1, 16-21
CrossRef85
Johnny R. McMinn, James N. George. (2001) Evaluation of women with clinically suspected thrombotic thrombocytopenic purpura-hemolytic uremic syndrome during pregnancy. Journal of Clinical Apheresis 16:4, 202-209
CrossRef86
Carlos A. Puyo. (2001) Thrombocytopenia. International Anesthesiology Clinics 39:1, 17-34
CrossRef87
Michael F. Murphy, Lorna M. Williamson. (2000) Antenatal screening for fetomaternal alloimmune thrombocytopenia: an evaluation using the criteria of the uk national screening committee. British Journal of Haematology 111:3, 726-732
CrossRef88
Kenneth A. Schwartz. (2000) GESTATIONAL THROMBOCYTOPENIA AND IMMUNE THROMBOCYTOPENIAS IN PREGNANCY. Hematology/Oncology Clinics of North America 14:5, 1101-1116
CrossRef89
V.S. Blanchette, J. Johnson, M. Rand. (2000) The management of alloimmune neonatal thrombocytopenia. Best Practice & Research Clinical Haematology 13:3, 365-390
CrossRef90
Hank Roqu
, Edmund Funai, Charles J. Lockwood. (2000) von Willebrand disease and pregnancy. The Journal of Maternal-Fetal Medicine 9:5, 257-266
CrossRef91
Karamjit K Gill, John G Kelton. (2000) Management of idiopathic thrombocytopenic purpura in pregnancy. Seminars in Hematology 37:3, 275-289
CrossRef92
Neil A Murray, Timothy L Watts, Irene A.G Roberts. (2000) Thrombopoietin in the fetus and neonate. Early Human Development 59:1, 1-12
CrossRef93
Hitoshi Ohto, Tomiko Yamaguchi, Chikako Takeuchi, Yuriko Tohyama, Akira Sato, Shoji Morita, . (2000) Anti-HPA-5b-induced neonatal alloimmune thrombocytopenia: antibody titre as a predictor. British Journal of Haematology 110:1, 223-227
CrossRef94
James N George. (2000) Platelets. The Lancet 355:9214, 1531-1539
CrossRef95
R. LUSH, H. ILAND, B. PEAT, G. YOUNG. (2000) Successful use of dapsone in refractory pregnancy-associated idiopathic thrombocytopenic purpura. Australian and New Zealand Journal of Medicine 30:1, 105-107
CrossRef96
L.J. Dumont, P. Krailadsiri, J. Seghatchian, L.A. Taylor, C.A. Howell, M.F. Murphy. (2000) Preparation and storage characteristics of white cell-reducedhigh-concentration platelet concentrates collected by anapheresis system for transfusions in utero. Transfusion 40:1, 91-100
CrossRef97
JEFFREY R. JOHNSON, PHILIP SAMUELS. (1999) Review of Autoimmune Thrombocytopenia: Pathogenesis, Diagnosis, and Management in Pregnancy. Clinical Obstetrics and Gynecology 42:2, 317-326
CrossRef98
NADINE SHEHATA, ROBERT BURROWS, JOHN G. KELTON. (1999) Gestational Thrombocytopenia. Clinical Obstetrics and Gynecology 42:2, 327-334
CrossRef99
Irene A. G. Roberts, Neil A. Murray. (1999) Management of thrombocytopenia in neonates. British Journal of Haematology 105:4, 864-870
CrossRef100
V. Gandemer, C. Kaplan, E. Quelvennec, P. Poulain, M. C. Laurent, G. Semana, J. Renouard, E. Le Gall. (1999) Pregnancy-associated autoimmune neonatal thrombocytopenia: role of maternal HLA genotype. British Journal of Haematology 104:4, 878-885
CrossRef101
Anne SYlvie VAlat, Marie THEREse CAUlier, Patrick Devos, Lucia Rugeri, BENEdicte Wibaut, PASCAl Vaast, Francis Puech, Francis Bauters, Brigitte Jude. (1998) Relationships between severe neonatal thrombocytopenia and maternal characteristics in pregnancies associated with autoimmune thrombocytopenia. British Journal of Haematology 103:2, 397-401
CrossRef102
Dwight J. Rouse, John Owen, Robert L. Goldenberg. (1998) Routine maternal platelet count: An assessment of a technologically driven screening practice. American Journal of Obstetrics and Gynecology 179:3, 573-576
CrossRef103
S. Hauser. (1998) Systemic lupus erythematosus (SLE) and neonatal morbidity and mortality. Australian and New Zealand Journal of Medicine 28:4, 482-482
CrossRef104
JAMES N. GEORGE, GARY E. RASKOB. (1998) Idiopathic Thrombocytopenic Purpura: Diagnosis and Management. The American Journal of the Medical Sciences 316:2, 87-93
CrossRef105
L.M. Williamson. (1998) Screening Programmes for Foetomaternal Alloimmune Thrombocytopenia. Vox Sanguinis 74:S2, 385-389
CrossRef106
ROBERT M. SILVER. (1998) Management of Idiopathic Thrombocytopenic Purpura in Pregnancy. Clinical Obstetrics and Gynecology 41:2, 436-448
CrossRef107
Sridharan Gururangan, Janice G. McFarland, Douglas B. Cines, Daniel Skupski, James B. Bussel. (1998) BRa (HPA-5b) Incompatibility May Cause Thrombocytopenia in Neonates of Mothers With Immune Thrombocytopenic Purpura. Journal of Pediatric Hematology/Oncology 20:3, 202-206
CrossRef108
Takeshi Asano, Rintaro Sawa, Tsutomu Arakf, Masao Yamamoto. (1998) Incidence of thrombocytopenia in infants born to mothers with idiopathic thrombocytopenic purpura. Pediatrics International 40:2, 112-115
CrossRef109
Leendert Porcelijn, Humphrey H. H. Kanhai. (1998) Fetal thrombocytopenia. Current Opinion in Obstetrics and Gynaecology 10:2, 117-122
CrossRef110
DE Moerloose, Boehlen, Extermann, Hohlfeld. (1998) Neonatal thrombocytopenia: incidence and characterization of maternal antiplatelet antibodies by MAIPA assay. British Journal of Haematology 100:4, 735-740
CrossRef111
James N George, Steven H Woolf, Gary E Raskob. (1998) Idiopathic thrombocytopenic purpura: a guideline for diagnosis and management of children and adults. Annals of Medicine 30:1, 38-44
CrossRef112
James B. Bussel. (1997) Immune thrombocytopenia in pregnancy: autoimmune and alloimmune. Journal of Reproductive Immunology 37:1, 35-61
CrossRef113
F. Mawas, E. Wiener, L. M. Williamson, C. H. Rodeck. (1997) Immunoglobulin G subclasses of anti-human platelet antigen la in maternal sera: relation to the severity of neonatal alloimmune thrombocytopenia. European Journal of Haematology 59:5, 287-292
CrossRef114
Theodore E. Warkentin, James W. Smith. (1997) The alloimmune thrombocytopenic syndromes. Transfusion Medicine Reviews 11:4, 296-307
CrossRef115
Susan D. Payne, Robert Resnik, Thomas R. Moore, Herman L. Hedriana, Thomas F. Kelly. (1997) Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial hemorrhage in pregnancies complicated by autoimmune thrombocytopenia. American Journal of Obstetrics and Gynecology 177:1, 149-155
CrossRef116
Simon Karpatkin. (1997) Autoimmune (idiopathic) thrombocytopenic purpura. The Lancet 349:9064, 1531-1536
CrossRef117
Maarten Knapen, Floor van Schaijk, Theo Mulder, Wilbert Peters, Eric Steegers. (1997) Marker for liver damage in neonates born to mothers with HELLP syndrome. The Lancet 349:9064, 1519-1520
CrossRef118
William R. Bell, Thomas S. Kickler. (1997) THROMBOCYTOPENIA IN PREGNANCY. Rheumatic Disease Clinics of North America 23:1, 183-194
CrossRef119
Hisanori Minakami, Tomoyuki Kuwata, Ikuo Sato. (1996) Gestational thrombocytopenia: Is it new?. American Journal of Obstetrics and Gynecology 175:6, 1676-1677
CrossRef120
K. E. King, K. J. Kao, P. F. Bray, J. F. Casella, K. Blakemore, N. A. Callan, S. D. Kennedy, T. S. Kickler. (1996) The role of HLA antibodies in neonatal thrombocytopenia: a prospective study. Tissue Antigens 47:3, 206-211
CrossRef121
Keith B. Lescale, Keith A. Eddleman, Douglas B. Cines, Philip Samuels, Martin L. Lesser, Janice G. McFarland, James B. Bussel. (1996) Antiplatelet antibody testing in thrombocytopenic pregnant women. American Journal of Obstetrics and Gynecology 174:3, 1014-1018
CrossRef122
Gregory A. Denomme, John S. Waye, Robert F. Borrows, Catherine P. M. Hayward, Theodore E. Warkentin, Peter Horsewood, James W. Smith, Russel D. Jelsema, Laura J. Zuidema, John G. Kelton. (1995) The prenatal identification of fetal compatibility in neonatal alloimmune thrombocytopenia using amniotic fluid and variable number of tandem repeat (VNTR) analysis. British Journal of Haematology 91:3, 742-746
CrossRef123
Robert M. Silver, D.Ware Branch, James R. Scott. (1995) Maternal thrombocytopenia in pregnancy: Time for a reassessment. American Journal of Obstetrics and Gynecology 173:2, 479-482
CrossRef124
I. Udom-Rice, J.B. Bussel. (1995) Fetal and neonatal thrombocytopenia. Blood Reviews 9:2, 57-64
CrossRef125
M. F. Murphy, A. H. Waters, H. A. Doughty, H. Hambley, R. S. Mibashan, K. Nicolaides, C. H. Rodeck. (1994) Antenatal management of fetomaternal alloimmune thrombocytopenia—report of 15 affected pregnancies. Transfusion Medicine 4:4, 281-292
CrossRef126
George, James N.El-Harake, Mayez A.Raskob, Gary E.. (1994) Chronic Idiopathic Thrombocytopenic Purpura. New England Journal of Medicine 331:18, 1207-1211
Full Text127
Eyal Anteby, Oded Shalev. (1994) Clinical relevance of gestational thrombocytopenia of <100,000/μl. American Journal of Hematology 47:2, 118-122
CrossRef128
(1994) Fetal and Maternal Thrombocytopenia. New England Journal of Medicine 330:13, 940-941
Full Text
- Letters
