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 ≤50×10(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. DISCUSSION: Our results suggest that antenatal maternal IVIG and, if necessary, postnatal matched platelet transfusions, are effective and safe for the treatment of FNAIT.
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 ≤50×10(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. DISCUSSION: Our results suggest that antenatal maternal IVIG and, if necessary, postnatal matched platelet transfusions, are effective and safe for the treatment of FNAIT.
Authors: M M Kamphuis; N Paridaans; L Porcelijn; M De Haas; C E Van Der Schoot; A Brand; G J Bonsel; D Oepkes Journal: BJOG Date: 2010-10 Impact factor: 6.531
Authors: Anne Davoren; Peter McParland; John Crowley; Anthony Barnes; Gabrielle Kelly; William G Murphy Journal: BJOG Date: 2003-05 Impact factor: 6.531
Authors: Jacqueline Kerr; Isabella Quinti; Martha Eibl; Helen Chapel; Peter J Späth; W A Carrock Sewell; Abdulgabar Salama; Ivo N van Schaik; Taco W Kuijpers; Hans-Hartmut Peter Journal: Front Immunol Date: 2014-12-12 Impact factor: 7.561