ALLOIMMUNE THROMBOCYTOPENIA - FETAL AND NEONATAL LOSSES RELATED TO CORDOCENTESIS

OBJECTIVE: This report describes the increased risks of cordocentesis in fetuses affected with alloimmune thrombocytopenia. STUDY DESIGN: As part of a multicenter treatment study clinical and laboratory data fr om five pregnancies with alloimmune thrombocytopenia in which there wa s a fetal or neonatal loss associated with cordocentesis were reviewed . The fetal or neonatal deaths were all thought to be a result of exsa nguination. These fetuses were compared with a group of 44 affected fe tuses who underwent the same procedure but who survived. The data were analyzed by the Wilcoxon rank-sum test and the two-tailed Fisher's ex act test. A p value < 0.05 was considered significant. RESULTS: The me an platelet count at cordocentesis was significantly lower in the case s than in the controls (5.8 vs 32.8 x 10(9)/L, p = 0.005). The inciden ce of antenatal intracranial hemorrhage in the untreated sibling of th e prior affected pregnancy was significantly greater in the cases than in the controls (two of five vs one of 42, p = 0.02). CONCLUSION: Fet uses affected with alloimmune thrombocytopenia are at increased risk f or fatal exsanguination associated with cordocentesis.