Management of fetal alloimmune thrombocytopenia by weekly in utero platelet transfusions.

Abstract:

:Alloimmune neonatal thrombocytopenia (ANT) may cause intracranial haemorrhage in utero as well as at delivery. Recent management has concentrated on attempts to minimise fetal thrombocytopenia and prevent its complications. This report describes further experience with the use of repeated intravascular transfusions of compatible platelets in utero. The patient studied had already had one infant with intracranial haemorrhage due to ANT. In her next pregnancy, weekly intra-uterine platelet transfusions were given from 26 weeks, but intra-uterine death occurred at 30 weeks after the mother had a heavy fall. In her most recent pregnancy, weekly intravascular transfusions of platelets were given by cordocentesis from 29 to 34 weeks. The fetal platelet count was maintained above 30 X 10(9)/l for almost all of the last 6 weeks of pregnancy before delivery of a normal infant by Caesarean section at 35 weeks' gestation. This approach is effective in preventing severe fetal thrombocytopenia in the last trimester of pregnancy and is contrasted with alternative treatments of ANT. Further data are required to determine the efficacy and risks of these treatments.

journal_name

Vox Sang

journal_title

Vox sanguinis

authors

Murphy MF,Pullon HW,Metcalfe P,Chapman JF,Jenkins E,Waters AH,Nicolaides KH,Mibashan RS

doi

10.1111/j.1423-0410.1990.tb02054.x

subject

Has Abstract

pub_date

1990-01-01 00:00:00

pages

45-9

issue

1

eissn

0042-9007

issn

1423-0410

journal_volume

58

pub_type

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