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.