From Womb to Recovery: Navigating Fetal and Neonatal Alloimmune Thrombocytopenia

Proposed Session Description: The session brings together a multidisciplinary team to highlight the full spectrum of care for patients with Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT). FNAIT is an immune-mediated thrombocytopenia occurring when maternal alloimmunization targets paternally inherited fetal platelet antigens, leading to fetal platelet destruction. It is a challenging and infrequently encountered hematologic condition in neonatal care. As advancements in donor testing and recruitment, platelet procurement, and clinical care evolve, long-held practices are being reshaped and no longer considered standard or optimal care.

The program chair will open the session by introducing recent cases of FNAIT at St. Louis Children's Hospital. These real-world cases will set the stage for a discussion leading into the diagnostic complexities and care management strategies of FNAIT.

Our first speaker, with specialized experience in platelet compatibility and reference-level immunohematology testing, will guide the audience through the current landscape and practical challenges of FNAIT diagnosis through various testing methodologies and the process of obtaining compatible platelets.

Our second speaker, a Pediatric Hematologist/Oncologist with a particular interest in immune-mediated thrombocytopenia, will discuss the current evidence-based medicine approach to caring for patients with suspected or proven FNAIT. Using the opening cases, the presenter will walk through treatment strategies and key clinical decisions faced when caring for fetal and neonatal patients with alloimmune thrombocytopenia. The speaker will also touch base on counseling for future pregnancies and the antenatal management algorithm.

Audience interaction will be scattered throughout the talk in the form of real-time audience polling to weigh in on diagnostic and therapeutic decisions that may arise during patient care of FNAIT.

A final Q&A segment will allow attendees to engage with the presenters to explore nuances relevant to their own clinical settings and practices.