Direct fetal administration of immunoglobulins: another disappointing therapy in alloimmune thrombocytopenia.
Current management strategies to prevent fetal intracranial haemorrhage in perinatal alloimmune thrombocytopenia (PAIT) include serial platelet transfusion and/or maternal high-dose intravenous immunoglobulin (IVIG) administration. The former involves multiple invasive procedures, while the latter is both expensive and of questionable efficacy. We report the use of direct fetal IVIG in 2 fetuses with PAIT, undergoing serial intrauterine platelet transfusions. Fetal IVIG had no effect on fetal platelet count. We conclude that direct fetal IVIG administration does not appear to have a role in the management of PAIT, and that current management strategies remain far from ideal.
Weiner
E
E
Centre for Fetal Care, Royal Postgraduate Medical School, London, UK.
Zosmer
N
N
Bajoria
R
R
Sepulveda
W
W
Vaughan
J I
JI
Letsky
E A
EA
Fisk
N M
NM
D000328:Adult; D005260:Female; D005312:Fetal Blood / Q000166:cytology; D005315:Fetal Diseases / Q000188:drug therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D007518:Isoantibodies; D010976:Platelet Count; D017713:Platelet Transfusion; D011247:Pregnancy; D013921:Thrombocytopenia / Q000188:drug therapy* / Q000276:immunology*
D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies