Neonatal alloimmune thrombocytopenia medical therapy

Neonatal alloimmune thrombocytopenia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Medical Therapy

During Pregnancy

The use of Intravenous immunoglobulin (IVIG) during pregnancy and immediately after birth has been shown to help reduce or alleviate the affects of NAIT in infants and reduce the severity of thrombocytopenia. The most common treatment is weekly IVIG infusions at a dosage of 1g/kg beginning at 20 weeks of pregnancy and continuing until the birth of the child. In some cases this dosage is increased to 2g/kg and/or combined with a regiment of Progesterone depending on the exact circumstances of the case. Although this treatment has not been shown to be effective in all cases it has been shown to reduce the severity of thrombocytopenia in some.

After Birth

The most rapidly effective treatment in infants with severe hemorrhage and/or severe thrombocytopenia (<30x10⁹/L) is the transfusion of compatible platelets (i.e. platelets from a donor who, like the mother lacks the causative antigen). Additionally if the thrombocytopenia in the infant at birth is not severe enough to warrant a transfusion of platelets (>30x10⁹/L) an infusion ofIVIG (1g/kg/day for two days) in the infant has been shown to rapidly increase platelet count and reduce the risk of related injury.