Fetal alloimmune thrombocytopenia and maternal intravenous immunoglobulin infusion.

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.

• Authors: Günther Giers, Folker Wenzel, Markus Stockschläder, Regina Riethmacher, Horst Lorenz, Boris Tutschek
• Journal: Haematologica (Haematologica) Vol. 95 Issue 11 Pg. 1921-6 (Nov 2010) ISSN: 1592-8721 [Electronic] Italy
• PMID: 20534698 (Publication Type: Journal Article)

Chemical References

• Immunoglobulin G
• Immunoglobulins, Intravenous
• Immunologic Factors

Topics

• Adult
• Female
• Humans
• Immunoglobulin G (administration & dosage)
• Immunoglobulins, Intravenous (administration & dosage)
• Immunologic Factors (administration & dosage)
• Infusions, Intravenous
• Platelet Count
• Pregnancy
• Retrospective Studies
• Thrombocytopenia, Neonatal Alloimmune (blood, drug therapy)