Fetomaternal alloimunne thrombocytopenia (FMAIT) is a disease of the fetus andneonate caused by anti-HPA antibodies produced by pregnant women in the course of an immune response to fetal HPA ...alloantigens inherited from the father. In whites, it is usually caused by the anti-HPA-1a (in 80-90% of cases), less frequently by anti-HPA-Sb (in 5-15% cases) and only rarely by other antibodies. Incidence of FMAIT is around 1.5 in 1,000 births and it is responsible for around 10% of all neonatal thrombocytopenias with a platelet count below 100x109/1. The fetus or the neonate with FMAIT displays mucosal and skin bleeding whereas in severe cases, intracranial haemorhages are observed with consequent neurological damage or death. The best treatment of FMAIT is a transfusion of HPA-compatible platelets. The use of i. v. immunoglobulins for pregnant women is less effective. If the fetus shows serious tendency of bleeding due to thrombocytopenia, regular weekly cordocenteses with intrauterine platelet transfusions are indicated. This treatment, however, still bears an approximately 2% mortality rate. Since the prevention of FMAIT is easier than its treatment and since the incidence of HPA-1a alloimmunizations in whites justifies the introduction of preventive screening tests, the question of a prenatal program for the detection of pregnancies at risk for FMAIT was raised, as in the case of routine testing for the prevention of haemolitic disease of the newborn.
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