Antenatal noninvasive treatment of patients at risk for alloimmune thrombocytopenia without a history of intracranial hemorrhage

Objective The purpose of this study was to evaluate noninvasive management of alloimmune thrombocytopenia that included only the blind administration of immunoglobulin. Study design Seventeen women with 30 pregnancies that were at risk of neonatal alloimmune thrombocytopenia were included. Except for 6 cases, in which the women refused treatment, 24 pregnancies were managed by the weekly administration of intravenous immunoglobulin without monitoring platelet count. Results The mean platelet count at birth after intravenous immunoglobulin treatment was 118,000/μL, compared with 25,000/μL among the 17 first affected infants and 24,000/μL among the 6 infants whose mothers refused treatment (P< .05). Only 8% of the treated fetuses had platelet counts of <30,000/μL at birth, compared with 70% of the untreated infants (P< .05). None of the treated and nontreated fetuses had an intracranial hemorrhage. Conclusion Noninvasive management of alloimmune thrombocytopenia that consists of only immunoglobulin administration is highly effective and seems safe in women without a history of fetal/neonatal intracranial hemorrhage.