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Haematologica. 2010 Nov;95(11):1921-6. doi: 10.3324/haematol.2010.025106. Epub 2010 Jun 9.

Fetal alloimmune thrombocytopenia and maternal intravenous immunoglobulin infusion.

Author information

1
Clinical Hemostaseology and Transfusion Medicine University Hospital Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany. giers@uni-duesseldorf.de

Abstract

BACKGROUND:

Different therapeutic approaches have been used in fetal-neonatal alloimmune thrombocytopenia, but many centers administer immunoglobulin G infusions to the pregnant woman. We studied the effect of maternal antenatal immunoglobulin infusions on fetal platelet counts in pregnancies with fetal alloimmune thrombocytopenia.

DESIGN AND METHODS:

We retrospectively analyzed the clinical courses of fetuses with fetal alloimmune thrombocytopenia whose mothers were treated with immunoglobulin G infusions in a single center between 1999 and 2005. In a center-specific protocol, weekly maternal immunoglobulin G infusions were given to 25 pregnant women with previously affected neonates and four women with strong platelet antibodies, but no previous history of fetal alloimmune thrombocytopenia; before each infusion diagnostic fetal blood sampling was performed to determine fetal platelet counts and immunoglobulin G levels.

RESULTS:

There were 30 fetuses with fetal alloimmune thrombocytopenia, confirmed by initial fetal blood sampling showing fetal platelet counts between 4×10(9)/L and 130×10(9)/L and antibody-coated fetal platelets using a glycoprotein specific assay. Despite weekly antenatal maternal immunoglobulin G infusions fetal platelet counts did not change significantly. Maternal and fetal immunoglobulin G levels, measured before every infusion, increased significantly with the number of maternal immunoglobulin G infusions.

CONCLUSIONS:

In this group of fetuses with fetal alloimmune thrombocytopenia no consistent increase of fetal platelets was achieved as a result of regular maternal immunoglobulin G infusions.

PMID:
20534698
PMCID:
PMC2966915
DOI:
10.3324/haematol.2010.025106
[Indexed for MEDLINE]
Free PMC Article

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