title: Fetal intracranial haemorrhages caused by fetal and neonatal alloimmune thrombocytopenia: an observational cohort study of 43 cases from an international multicentre registry.
abstract: OBJECTIVE
  To characterise pregnancies where the fetus or neonate was diagnosed with fetal and neonatal alloimmune thrombocytopenia (FNAIT) and suffered from intracranial haemorrhage (ICH), with special focus on time of bleeding onset.
  
  
  METHODS
  Observational cohort study of all recorded cases of ICH caused by FNAIT from the international No IntraCranial Haemorrhage (NOICH) registry during the period 2001-2010.
  
  
  METHODS
  13 tertiary referral centres from nine countries across the world.
  
  
  METHODS
  37 mothers and 43 children of FNAIT pregnancies complicated by fetal or neonatal ICH identified from the NOICH registry was included if FNAIT diagnosis and ICH was confirmed.
  
  
  METHODS
  Gestational age at onset of ICH, type of ICH and clinical outcome of ICH were the primary outcome measures. General maternal and neonatal characteristics of pregnancies complicated by fetal/neonatal ICH were secondary outcome measures.
  
  
  RESULTS
  From a total of 592 FNAIT cases in the registry, 43 confirmed cases of ICH due to FNAIT were included in the study. The majority of bleedings (23/43, 54%) occurred before 28 gestational weeks and often affected the first born child (27/43, 63%). One-third (35%) of the children died within 4 days after delivery. 23 (53%) children survived with severe neurological disabilities and only 5 (12%) were alive and well at time of discharge. Antenatal treatment was not given in most (91%) cases of fetal/neonatal ICH.
  
  
  CONCLUSIONS
  ICH caused by FNAIT often occurs during second trimester and the clinical outcome is poor. In order to prevent ICH caused by FNAIT, at-risk pregnancies must be identified and prevention and/or interventions should start early in the second trimester.
authors.affiliation: Department of Obstetrics and Gynaecology, University Hospital North Norway, Tromsø, Norway.
authors.forename: Heidi
authors.initials: H
authors.lastname: Tiller
authors.forename: Marije M
authors.initials: MM
authors.lastname: Kamphuis
authors.forename: Olof
authors.initials: O
authors.lastname: Flodmark
authors.forename: Nikos
authors.initials: N
authors.lastname: Papadogiannakis
authors.forename: Anna L
authors.initials: AL
authors.lastname: David
authors.forename: Susanna
authors.initials: S
authors.lastname: Sainio
authors.forename: Sinikka
authors.initials: S
authors.lastname: Koskinen
authors.forename: Kaija
authors.initials: K
authors.lastname: Javela
authors.forename: Agneta Taune
authors.initials: AT
authors.lastname: Wikman
authors.forename: Riitta
authors.initials: R
authors.lastname: Kekomaki
authors.forename: Humphrey H H
authors.initials: HH
authors.lastname: Kanhai
authors.forename: Dick
authors.initials: D
authors.lastname: Oepkes
authors.forename: Anne
authors.initials: A
authors.lastname: Husebekk
authors.forename: Magnus
authors.initials: M
authors.lastname: Westgren