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Abstract

NAIT is a rare disorder with a similar aetiology to HDN, however unlike its erythrocyte counterpart, thrombocyte immunisation can occur within the first pregnancy. (Giouleka et al., 2023). The most common antibodies implicated are HLA-1a. (Winkelhorst et al., 2017). 2.5% of the Caucasian population are HPA-1a negative, of this population 33% are HLA-DR-B3*0101 positive increasing the risk of producing an alloantibody upon encountering the HPA-1a antigen. The maternal system becomes alloimmunised to the foreign paternal antigens of the foetus/neonate, which cross the placenta causing low platelets of the foetus. (Giouleka et al., 2023).

A third of antigen-positive neonates born to antigen-negative mothers develop thrombocytopenia with a platelet count lower than 50x109/L. (Giouleka et al., 2023). There is a significant risk (10%) of ICH due to thrombocytopenia. (Giouleka et al., 2023). The disorder is identified through physical manifestations of thrombocytopenia, the neonate may also be asymptomatic, and the low platelet implicated incidentally.(Constantinesu et al. 2012) (Paidas, 2023). Using the success of prenatal screening programmes for HDN non-invasive prenatal testing for NAIT would allow for early intervention and prevent harm to the foetus.

Currently, there is no consensus on the management of NAIT. A prophylactic treatment has seen success in clinical trials, if brought to market this drug could become the gold standard in preventing maternal immunisation. (Giouleka et al., 2023) (Winkelhorst et al., 2017) (Zhi et al., 2022).

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