title: Neonatal outcome in alloimmune thrombocytopenia after maternal treatment with intravenous immunoglobulin.
abstract: BACKGROUND
  Weekly maternal intravenous immunoglobulin (IVIG) is the cornerstone of antenatal treatment of foetal and neonatal alloimmune thrombocytopenia (FNAIT). The aim of this study was to describe the neonatal outcome and management in neonates with FNAIT treated antenatally with IVIG.
  
  
  METHODS
  All neonates treated antenatally and delivered at our centre between 2006 and 2012 were included in the study. We assessed the neonatal outcome and management, including the occurrence of intracranial haemorrhage, platelet count at birth and need for postnatal platelet transfusions or postnatal IVIG treatment.
  
  
  RESULTS
  A total of 22 neonates were included of whom 12 (55%) had severe thrombocytopenia at birth (platelet count ≤50×10(9)/L). Most neonates (67%, 8/12) with severe thrombocytopenia received a platelet transfusion after birth. None of the neonates required postnatal treatment with IVIG. Three neonates had petechiae and haematomas, without clinical consequences. One foetus suffered from intracranial haemorrhage, which was detected just before the planned start of antenatal IVIG at 28 weeks' gestation.
  
  
  CONCLUSIONS
  Our results suggest that antenatal maternal IVIG and, if necessary, postnatal matched platelet transfusions, are effective and safe for the treatment of FNAIT.
authors: Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
authors: N Margreth
authors: NM
authors: Van Der Lugt
authors: Department of Obstetrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Marije M
authors: MM
authors: Kamphuis
authors: Department of Obstetrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Noortje P M
authors: NP
authors: Paridaans
authors: Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Anouk
authors: A
authors: Figee
authors: Department of Obstetrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Dick
authors: D
authors: Oepkes
authors: Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Frans J
authors: FJ
authors: Walther
authors: Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, The Netherlands.
authors: Enrico
authors: E
authors: Lopriore
mesh_terms: D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage*; D007231:Infant, Newborn; D008297:Male; D017713:Platelet Transfusion; D011247:Pregnancy; D054098:Thrombocytopenia, Neonatal Alloimmune / Q000628:therapy*
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors