OBJECTIVE: We sought to prevent intracranial hemorrhage (ICH) through antenatal management of alloimmune thrombocytopenia. STUDY DESIGN: A total of 33 women (37 pregnancies) with alloimmune thrombocytopenia and ICH in a previous child were stratified according to the timing of the previous child's ICH: extremely high risk (HR) (n = 8) had ICH <28 weeks, very HR (n = 17) between 28-36 weeks, and HR (n = 12) in the perinatal period. Treatment was initiated at 12 weeks with intravenous immunoglobulin 1 or 2 g/kg/wk, and if the fetal platelet count by cordocentesis was <30,000/mL despite treatment, prednisone and/or more intravenous immunoglobulin were added. RESULTS: Five of 37 fetuses suffered ICHs. Two ICHs had platelet counts >100,000/mL, and 1 was grade I. The other 2 ICHs were unequivocal treatment failures; both were grade III-IV and resulted in fetal demise. CONCLUSION: These findings demonstrate the success of stratified treatment in these HR patients, which tailored interventions according to the timing of the sibling's ICH. Copyright (c) 2010 Mosby, Inc. All rights reserved.
OBJECTIVE: We sought to prevent intracranial hemorrhage (ICH) through antenatal management of alloimmune thrombocytopenia. STUDY DESIGN: A total of 33 women (37 pregnancies) with alloimmune thrombocytopenia and ICH in a previous child were stratified according to the timing of the previous child's ICH: extremely high risk (HR) (n = 8) had ICH <28 weeks, very HR (n = 17) between 28-36 weeks, and HR (n = 12) in the perinatal period. Treatment was initiated at 12 weeks with intravenous immunoglobulin 1 or 2 g/kg/wk, and if the fetal platelet count by cordocentesis was <30,000/mL despite treatment, prednisone and/or more intravenous immunoglobulin were added. RESULTS: Five of 37 fetuses suffered ICHs. Two ICHs had platelet counts >100,000/mL, and 1 was grade I. The other 2 ICHs were unequivocal treatment failures; both were grade III-IV and resulted in fetal demise. CONCLUSION: These findings demonstrate the success of stratified treatment in these HR patients, which tailored interventions according to the timing of the sibling's ICH. Copyright (c) 2010 Mosby, Inc. All rights reserved.
Authors: Cedric Ghevaert; Nina Herbert; Louise Hawkins; Nicola Grehan; Philip Cookson; Steve F Garner; Abigail Crisp-Hihn; Paul Lloyd-Evans; Amanda Evans; Kottekkattu Balan; Willem H Ouwehand; Kathryn L Armour; Mike R Clark; Lorna M Williamson Journal: Blood Date: 2013-05-08 Impact factor: 22.113
Authors: N Margreth Van Der Lugt; Marije M Kamphuis; Noortje P M Paridaans; Anouk Figee; Dick Oepkes; Frans J Walther; Enrico Lopriore Journal: Blood Transfus Date: 2014-06-19 Impact factor: 3.443
Authors: Heidi Tiller; Marije M Kamphuis; Olof Flodmark; Nikos Papadogiannakis; Anna L David; Susanna Sainio; Sinikka Koskinen; Kaija Javela; Agneta Taune Wikman; Riitta Kekomaki; Humphrey H H Kanhai; Dick Oepkes; Anne Husebekk; Magnus Westgren Journal: BMJ Open Date: 2013-03-22 Impact factor: 2.692