Antenatal noninvasive treatment of patients at risk for alloimmune thrombocytopenia without a history of intracranial hemorrhage

Am J Obstet Gynecol. 2006 Oct;195(4):1153-7. doi: 10.1016/j.ajog.2006.06.066.

Abstract

Objective: The purpose of this study was to evaluate noninvasive management of alloimmune thrombocytopenia that included only the blind administration of immunoglobulin.

Study design: 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.

Conclusion: 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.

MeSH terms

  • Adult
  • Antigens, Human Platelet / immunology*
  • Blood Specimen Collection / adverse effects
  • Female
  • Fetal Diseases / therapy*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Infant, Newborn
  • Integrin beta3
  • Intracranial Hemorrhages / etiology*
  • Platelet Count
  • Pregnancy
  • Thrombocytopenia / therapy*

Substances

  • Antigens, Human Platelet
  • ITGB3 protein, human
  • Immunoglobulins, Intravenous
  • Integrin beta3