Platelet conflict occurs as a result of an incompatibility between the mother's blood and that of the fetus. It does not cause any symptoms during pregnancy, problems usually begin in the perinatal period. The consequences of the platelet conflict can be very serious for the fetus. How is a plate conflict detected and what is the management implemented?

Platelet conflictis one of the conflicts that may arise in pregnancy as a result of incompatibility between the blood components of the mother and the fetus.

The main function of platelets is their ability to initiate the clotting process. There are specific antigens on the surface of platelets, as well as many other morphotic components of the blood.

The HPA-1a antigens are involved in the process of the platelet conflict.

The presence of certain antigens is genetically determined, therefore, as in the case of blood groups, a child may inherit platelet antigens from the mother or father.

If a child inherits from the father the HPA-1a antigen, and the mother does not have it on her cells, her body produces antibodies against this antigen during pregnancy. This is because the blood of the fetus and mother systematically "mix" with each other.

Therefore, if the mother's immune system "realizes" that there are no platelets circulating in her blood with this antigen, it treats them as a so-called "intruder" and tries to destroy them.

As a consequence of the platelet conflict, the baby's blood platelets are fought and they may develop thrombocytopenia.

In the context of the platelet conflict, we are talking about alloimmune thrombocytopenia of fetuses and newborns (AIMP / N).

How often does a plate conflict occur?

Plate conflict occurs in 1 in 1,000-2,000 full-term pregnancies. Unfortunately, its occurrence is associated with high mortality in newborns, estimated at about 10%, and bleeding into the central nervous system is considered the main cause of death.

How to detect a plate conflict?

A detailed blood group test is very important, not only for Rh but also for maternal anti-platelet antibodies.

It should also be mentioned that, unlike the serological conflict regarding the Rh factor, it is a conflictlamellar is revealed from the very first pregnancy.

Moreover, it has been proven that the severity of the platelet conflict is greater in each subsequent pregnancy.

Therefore, it is important to remember, above all, that the only way to detect platelet conflict early is to test the mother's blood for the presence of the HPA-1a antigen.

If the test detects the aforementioned antigen in the mother, the development of a platelet conflict will not occur. However, in the absence of HPA-1a in the mother, it is necessary to examine whether it is present in the child. If not, there will be no plate conflict as well.

Otherwise, we can expect the mother's immune system to produce antibodies to destroy the fetal blood platelets.

Of course, this is not a binary issue, and not every HPA-1a negative mother will produce antibodies, and not all antibodies will lead to the development of serious complications for the fetus.

Plate conflict: fetal complications

A plate conflict can lead to complications in the fetus, such as:

  • intracranial haemorrhages
  • mental retardation
  • epilepsy
  • cerebral palsy

The platelet conflict can also be asymptomatic, but the most common symptoms are thrombocytopenia of various degrees and the associated ecchymosis, skin and mucosal effusions.

The platelet conflict, despite being a very serious and dangerous disease, does not manifest itself in any way during pregnancy.

Both pregnancies without and with platelet conflict will develop properly, only in the perinatal period the abovementioned disorders will become apparent.

Category:

Pregnant examinations