Researchers at WEHI (The Walter and Eliza Hall Institute) have found a new method to assist identify baby and foetuses at high-risk of developing brain bleeding, paving the way for improved early intervention.
Unborn babies may be impacted by brain bleeds, which can lead to stroke and permanent neurological problems, such as cerebral palsy.
Although brain bleeds can be dealt with with platelet transfusions, the invasive procedures may be dangerous, and it had been unclear which babies would benefit most.
At a glance, I''ll see how things change.
- Research finds a new way to help identify unborn and newborn babies at risk of brain bleeds.
- Preclinical studies show brain bleeds will occur if platelet levels drop to 10 per cent or below in foetuses and newborns.
- The new threshold could be used to determine which babies should have treatment, transforming platelet transfusion practises and avoiding unnecessary procedures.
Dr Alison Farley and Dr Samir Taoudi, scientists at WEHI, are examining how platelets, small blood cells known for facilitating blood clots, affect brain bleeds to better understand when platelet transfusion should be carried out.
Brain bleeds have always occurred when platelet levels have dropped to ten percent or below in newborns and foetuses, according to a new study of preclinical models.
Further research suggests that babies may develop protection against brain bleeding two weeks after birth, which has resulted in poor platelet levels becoming more prevalent.
The study, published inBlood, identifies the way to better understand which babies should receive a platelet transfusion and how the platelet threshold may be set to, in order to avoid unnecessary transfusions.
Low platelet levels, a condition known as thrombocytopenia, may be associated with excessive bleeding, and is common in preterm infants.
Researchers were able to discern three levels of platelet counts that correlated brain bleed risk by studying varying degrees of thrombocytopenia in pre-clinical studies.
If their platelet count was below 10%, they discovered brain bleeds in unborn or newborn babies were guaranteed.
Although a moderate platelet level between 10 and 40% might lead to a brain bleed, babies with more than 40% of platelets were at risk of developing the condition.
Platelet transfusions are currently given to babies in a moderate range, who may not even experience brain bleeds, according to Dr Farley.
It is critically important to look at the sluggish levels of platelet concentrations that will always lead to brain bleeds, and the extent that may not.
Our findings may help determine which babies may safely receive a platelet transfusion after birth, and where the threshold might be lowered to avoid unnecessary and dangerous transfusions.
If the loss of platelets occurs within days after birth, then this may provide a window for a variety of interventions, allowing for severe brain bleeds and stroke in babies.
Analyzing why protection against brain bleeds forms two weeks after birth would be an important next step, as well as discovering which proteins and genes are involved.
Dr Taoudi said that we need to see how platelets and brain blood vessels work together to improve brain bleeding resistance.
What we will do next is to understand if brain bleeds are caused by a communication breakdown between platelets and blood vessels, or if they are being caused by environmental factors?