Antenatal noninvasive treatment of patients at risk for alloimmune thrombocytopenia without a history of intracranial hemorrhage.
OBJECTIVE
The purpose of this study was to evaluate noninvasive management of alloimmune thrombocytopenia that included only the blind administration of immunoglobulin.


METHODS
Seventeen women with 30 pregnancies that were at risk of neonatal alloimmune thrombocytopenia were included. Except for 6 cases, in which the women refused treatment, 24 pregnancies were managed by the weekly administration of intravenous immunoglobulin without monitoring platelet count.


RESULTS
The mean platelet count at birth after intravenous immunoglobulin treatment was 118,000/microL, compared with 25,000/microL among the 17 first affected infants and 24,000/microL among the 6 infants whose mothers refused treatment (P < .05). Only 8% of the treated fetuses had platelet counts of <30,000/microL at birth, compared with 70% of the untreated infants (P < .05). None of the treated and nontreated fetuses had an intracranial hemorrhage.


CONCLUSIONS
Noninvasive management of alloimmune thrombocytopenia that consists of only immunoglobulin administration is highly effective and seems safe in women without a history of fetal/neonatal intracranial hemorrhage.
Yinon
Yoav
Y
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel. yinony@barak-online.net
Spira
Maya
M
Solomon
Ofira
O
Weisz
Boaz
B
Chayen
Benjamin
B
Schiff
Eyal
E
Lipitz
Shlomo
S
D000328:Adult; D016824:Antigens, Human Platelet / Q000276:immunology*; D001800:Blood Specimen Collection / Q000009:adverse effects; D005260:Female; D005315:Fetal Diseases / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007231:Infant, Newborn; D039661:Integrin beta3; D020300:Intracranial Hemorrhages / Q000209:etiology*; D010976:Platelet Count; D011247:Pregnancy; D013921:Thrombocytopenia / Q000628:therapy*
D016824:Antigens, Human Platelet; C061248:ITGB3 protein, human; D016756:Immunoglobulins, Intravenous; D039661:Integrin beta3