Blood Transfusion - 1 2015

Neonatal outcome in alloimmune thrombocytopenia after maternal treatment with intravenous immunoglobulin
Authors:  N. Margreth van der Lugt, Marije M. Kamphuis, Noortje P.M. Paridaans, Anouk Figee, Dick Oepkes, Frans J. Walther, Enrico Lopriore
Pages:  66-71
To cite this article:  Blood Transfus 2015; 13: 66-71
Doi:  10.2450/2014.0309-13
Published online:  19/06/2014

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.
Materials and 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 ≤50×109/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.
Discussion. Our results suggest that antenatal maternal IVIG and, if necessary, postnatal matched platelet transfusions, are effective and safe for the treatment of FNAIT.
Keywords: alloimmune thrombocytopenia, neonatal, intravenous immunoglobulin, intracranial haemorrhage.
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