Therapy with intravenous immunoglobulin G (ivIgG) during pregnancy for fetal alloimmune (HPA-1a(Zwa)) thrombocytopenic purpura.

Abstract:

:We have evaluated the effect of maternal intravenous immunoglobulin G (ivIgG) treatment on platelet counts in fetal alloimmune thrombocytopenia. Seven patients were studied. All of them were multiparous women who had been immunized against the HPA-1a antigen during previous pregnancies and had given birth to at least one severely thrombocytopenic infant. In this study, umbilical blood collection was performed first at the 20th week of gestation and repeated 2-13 times (mean 6 times), depending on the degree of fetal thrombocytopenia. Fetal platelet counting was combined with intrauterine transfusion of 20-30 ml of HPA-1a-negative platelet concentrates to prevent bleeding following umbilical cord puncture. Initial fetal platelet counts ranged from 10,000 to 91,000 per microliters. Maternal treatment with ivIgG (1 g per kg body weight; mean dose 70 g) was given once a week over 7 weeks. In five of seven cases, the basal platelet count did not rise and in two of these cases, it decreased during maternal ivIgG treatment. In one fetus, the baseline platelet count increased from 10,000 to 35,000 per microliters during ivIgG, and in another fetus from 23,000 to 64,000 per microliters. Our observations suggest that ivIgG has no definite benefit for fetal alloimmune thrombocytopenia. Since platelet counts can be very low, careful fetal monitoring by umbilical blood sampling is required. Frequent platelet transfusions in short intervals may be necessary to increase platelet counts in extremely thrombocytopenic fetuses.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Giers G,Hoch J,Bauer H,Bald R,Kiefel V,Kroll H,Hansmann M,Hanfland P,Mueller-Eckhardt C,Scharf RE

doi

10.1002/(SICI)1097-0223(199606)16:6<495::AID-PD899

subject

Has Abstract

pub_date

1996-06-01 00:00:00

pages

495-502

issue

6

eissn

0197-3851

issn

1097-0223

pii

10.1002/(SICI)1097-0223(199606)16:6<495::AID-PD899

journal_volume

16

pub_type

杂志文章
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    更新日期:1989-10-01 00:00:00

  • Mosaicism for trisomy 12: four cases with varying outcomes.

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    更新日期:1995-11-01 00:00:00

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    更新日期:2016-12-01 00:00:00

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    authors: Jaques AM,Sheffield LJ,Halliday JL

    更新日期:2005-08-01 00:00:00

  • French midwives' practice of termination of pregnancy for fetal abnormality. At what psychological and ethical cost?

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    authors: Garel M,Etienne E,Blondel B,Dommergues M

    更新日期:2007-07-01 00:00:00

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    journal_title:Prenatal diagnosis

    pub_type: 杂志文章

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    authors: Beattie MJ,Friedman KG,Sleeper LA,Lu M,Drogosz M,Callahan R,Marshall AC,Prosnitz AR,Lafranchi T,Benson CB,Wilkins-Haug LE,Tworetzky W

    更新日期:2021-01-18 00:00:00

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    pub_type: 杂志文章

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    更新日期:1999-08-01 00:00:00

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    更新日期:2005-05-01 00:00:00

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    更新日期:2000-02-01 00:00:00

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    更新日期:2015-05-01 00:00:00

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    更新日期:1995-05-01 00:00:00

  • Types II and III congenital pulmonary airway malformation with hydrops treated in utero with percutaneous sclerotherapy.

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