ABSTRACT
Allolmmune-Medlsted Platelet Disorders 333
bleeding and initial fetal platelet count > 50,000/JJl in this study). The platelet counts were maintained in one case with steroids and in three with immunoglobulin without the need for repeated platelet transfusions. but in the fifth the fetal platelet count fell despite steroids and immunoglobulin and serial platelet transfusions were required. Four pregnancies were unsuccessful: two pregnancies were terminated after severe intracranial hemorrhage occurred at an early stage before fetal blood sampling had been carried out; one fetus died after the mother had a severe fall despite the successful initiation of fetal platelet transfusions; and one died due to a cord hematoma that occurred at the time of the initial fetal blood sampling. The optimal management of neonatal alloimmune thrombocytopenia to reduce the risk of antenatal intracranial hemorrhage remains uncertain. Steroids and immunoglobulin may be effective in some mildly affected cases, but serial fetal platelet transfusions are the preferred therapy for those who are severely affected.
