Murphy M F, Pullon H W, Metcalfe P, Chapman J F, Jenkins E, Waters A H, Nicolaides K H, Mibashan R S
Department of Haematology, St. Bartholomew's Hospital and Medical College, London, UK.
Vox Sang. 1990;58(1):45-9. doi: 10.1111/j.1423-0410.1990.tb02054.x.
Alloimmune neonatal thrombocytopenia (ANT) may cause intracranial haemorrhage in utero as well as at delivery. Recent management has concentrated on attempts to minimise fetal thrombocytopenia and prevent its complications. This report describes further experience with the use of repeated intravascular transfusions of compatible platelets in utero. The patient studied had already had one infant with intracranial haemorrhage due to ANT. In her next pregnancy, weekly intra-uterine platelet transfusions were given from 26 weeks, but intra-uterine death occurred at 30 weeks after the mother had a heavy fall. In her most recent pregnancy, weekly intravascular transfusions of platelets were given by cordocentesis from 29 to 34 weeks. The fetal platelet count was maintained above 30 X 10(9)/l for almost all of the last 6 weeks of pregnancy before delivery of a normal infant by Caesarean section at 35 weeks' gestation. This approach is effective in preventing severe fetal thrombocytopenia in the last trimester of pregnancy and is contrasted with alternative treatments of ANT. Further data are required to determine the efficacy and risks of these treatments.
同种免疫性新生儿血小板减少症（ANT）可在子宫内以及分娩时导致颅内出血。近期的治疗重点在于尽量减少胎儿血小板减少症并预防其并发症。本报告描述了在子宫内重复输注相容血小板的更多经验。所研究的患者已有一名因ANT导致颅内出血的婴儿。在她的下一胎妊娠中，从孕26周开始每周进行宫内血小板输注，但在母亲严重跌倒后，孕30周时发生了宫内死亡。在她最近一次妊娠中，从孕29周到34周通过脐血穿刺每周进行血管内血小板输注。在妊娠最后6周的几乎整个期间，胎儿血小板计数维持在30×10⁹/L以上，之后在孕35周时通过剖宫产分娩出一名正常婴儿。这种方法在预防妊娠晚期严重胎儿血小板减少症方面有效，并且与ANT的其他治疗方法形成对比。需要更多数据来确定这些治疗方法的疗效和风险。
