From the Divisions of Maternal Fetal Medicine and Surgical Critical Care, Departments of Obstetrics & Gynecology and Anesthesiology, The University of Texas Medical Branch at Galveston; Division of Maternal fetal Medicine, Department of Obstetrics & Gynecology, Columbia University Medical Center; Department of Obstetrics & Gynecology and Reproductive Sciences, University of Texas School of Medicine, Houston, Texas; Department of Obstetrics & Gynecology and Pediatrics, Weill Medical College of Cornell University, New York, New York; Division of Hematology-Oncology, Department of Medicine, Medical College of Wisconsin, and Platelet and Neutrophil Immunology Laboratory, BloodCenter of Wisconsin; Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston.
Obstet Gynecol. 2011 Nov;118(5):1157-1163. doi: 10.1097/AOG.0b013e31823403f4.
Fetal and neonatal alloimmune thrombocytopenia constitutes the most common cause of severe thrombocytopenia in fetuses and neonates and of intracranial hemorrhage among term newborns. The cornerstone of therapy involves the use of steroids and intravenous immunoglobulins. Despite the risk of potentially devastating consequences to the fetus, fetal blood sampling has typically been used to document response to therapy. We propose a therapeutic algorithm based on risk stratification with individualized treatment optimization without the use of fetal blood sampling.
胎儿和新生儿同种免疫性血小板减少症是胎儿和新生儿严重血小板减少症以及足月新生儿颅内出血的最常见原因。治疗的基石包括使用类固醇和静脉注射免疫球蛋白。尽管胎儿可能会有潜在的灾难性后果，但通常会进行胎儿血液采样以记录对治疗的反应。我们提出了一种基于风险分层的治疗算法，通过个体化治疗优化，而不使用胎儿血液采样。
