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Clinical uses of intravenous immunoglobulin in pregnancy

      Abstract

      Intravenous immunoglobulin was licensed for use in the United States in 1981. Currently, there are only a few Food and Drug Administration–labeled indications for intravenous immunoglobulin, but up to 50 “off-label” uses are reported in the literature. The obstetric literature contains numerous reports on intravenous immunoglobulin therapy during pregnancy. This article reviews the properties, pharmacokinetics, mechanisms of action, and side effects of intravenous immunoglobulin, as well as the reported uses of intravenous immunoglobulin during pregnancy. (Am J Obstet Gynecol 1997;176:241-53.)

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      References

        • Bruton OC
        Agammaglobulinemias.
        Pediatrics. 1952; 9: 722-727
        • Ratko T
        • Burnett D
        • Foulke G
        • Matuszewski K
        • Sacher R
        Recommendations for off-label use of intravenously administered immunoglobulin preparations.
        JAMA. 1995; 273: 1865-1870
        • Stiehm R
        • Ashida E
        • Kim K
        • Winston D
        • Haas A
        • Gayle R
        Intravenous immunoglobulins as therapeutic agents.
        Ann Intern Med. 1987; 107: 367-382
      1. Use of approved drugs for unlabeled indications.
        FDA Drug Bull. 1982; 12 (Apr): 4-5
        • Berkman S
        • Lee M
        • Gale R
        Clinical uses of intravenous immunoglobulins.
        Ann Intern Med. 1990; 112: 278-292
        • Dwyer J
        Manipulating the immune system with immune globulin.
        N Engl J Med. 1992; 326: 107-116
        • Terry WD
        • Fahey JL
        Subclasses of human gamma2-globulin based on differences in the heavy polypeptide chains.
        Science. 1964; 146: 400
        • Yount WJ
        • Dorner MM
        • Kunkel HG
        • Kabat EE
        Studies on human antibodies. VI. Selective variations in subgroup composition and genetic markers.
        J Exp Med. 1968; 127: 633-646
        • ASHP Commission on Therapeutics
        ASHP therapeutic guidelines for intravenous immune globulin.
        Clin Pharmacokinet. 1992; 11: 117-136
        • Friedli H
        Methodology and safety considerations in the production of an intravenous immunoglobulin preparation.
        Pharmacotherapy. 1987; 7: 36S-40S
      2. Immunodeficiency: Report of a WHO scientific group. World Health Organization, Geneva1978: 3-80 (WHO Technical Report Series No.: 630)
        • Steele R
        • Burks W
        • Williams L
        Intravenous immunoglobulin: new clinical applications.
        Ann Allergy Asthma Immunol. 1988; 60: 89-95
        • Barandun S
        • Kistler P
        • Jeunet F
        • Isliker H
        Intravenous administration of human gamma-globulin.
        Vox Sang. 1962; 7: 157-174
        • Kistler P
        • Steiger G
        Human immunoglobulins for intravenous administration: preparation and properties.
        Progr Immunobiol. 1970; 4: 92-94
        • Ochs HD
        • Morell A
        • Skvail F
        • Fischer SH
        • Wedgwood RJ
        Survival of IgG subclasses following administration of intravenous gammaglobulin in patients with primary immunodeficiency diseases.
        in: Clinical uses of intravenous immunoglobulins. Academic Press, London1986: 77-85
        • Pirofsky B
        Safety and toxicity of a new serum immunoglobulin G intravenous preparation, IGIV pH 4.25.
        Rev Infect Dis. 1986; 8: S457-S463
        • Smith EL
        • Hill RL
        • Lehman IR
        • Lefkowitz RJ
        • Handler P
        • White A
        7th ed. Principles of biochemistry: mammalian biochemistry. McGraw Hill, Tokyo1983: 40
        • Nolte MT
        • Pirofsky B
        • Gerritz GA
        • Golding B
        Intravenous immunoglobulin therapy for antibody deficiency.
        Clin Exp Immunol. 1979; 36: 237-243
        • Pirofsky B
        Intravenous immune globulin therapy in hypogammaglobulinema: a review.
        Am J Med. 1984; 76: 53-60
        • Ochs HD
        • Fischer SH
        • Wedgwood RJ
        • et al.
        Comparison of high-dose and low-dose intravenous immunoglobulin therapy in patients with primary immunodeficiency diseases.
        Am J Med. 1984; 76: S78-S82
        • Schiff RI
        Half-life and clearance of pH 6.8 and pH 4.25 immunoglobulin G intravenous preparations in patients with primary disorders of humoral immunity.
        Rev Infect Dis. 1986; 8: S456-S463
        • Pirofsky B
        • Kinzey DM
        Intravenous immune globulins. A review of their uses in selected immunodeficiency and autoimmune diseases.
        Drugs. 1992; 43: 6-14
        • Fehr J
        • Hofmann V
        • Kappeler U
        Transient reversal of thrombocytopenia in idiopathic thrombocytopenic purpura by high-dose intravenous gamma globulin.
        N Engl J Med. 1982; 306: 1254-1258
        • Kimberly RP
        • Salmon JE
        • Bussel JB
        • Crow MK
        • Hilgartner MW
        Modulation of mononuclear phagocyte function by intravenous gamma-globulin.
        J Immunol. 1984; 132: 745-750
        • Newland AC
        The use and mechanisms of action of intravenous immunoglobulin: an update.
        Br J Haematol. 1989; 72: 301-305
        • Bussel J
        • Pahwa S
        • Porges A
        • et al.
        Correlation of in vitro antibody synthesis with the outcome of intravenous gamma-globulin treatment of chronic idiopathic thrombocytopenic purpura.
        J Clin Immunol. 1986; 6: 50-56
        • Spinnato JA
        • Clark AC
        • Pierangeli SS
        • Harris EN
        Intravenous immunoglobulin therapy for the antiphospholipid syndrome in pregnancy.
        Am J Obstet Gynecol. 1995; 172: 690-694
        • Sultan Y
        • Kazatchkine MD
        • Maisonneuve P
        • Nydegger UE
        Anti-idiotypic suppression of autoantibodies to factor VIII by high-dose intravenous gammaglobulin.
        Lancet. 1984; 2: 765-768
        • Delfraissy JF
        • Tchernia G
        • Laurian Y
        • Wallon C
        • Galanaud P
        • Dormont J
        Suppressor cell function after intravenous gammaglobulin treatment in adult chronic idiopathic thrombocytopenic purpura.
        Br J Haematol. 1985; 60: 315-322
        • Abdou NI
        • Wall H
        • Lindsley HB
        • Hasley JF
        • Susuki T
        Network theory in autoimmunity: in vitro suppression of serum anti-DNA antibody binding to DNA by anti-idiotypic antibody in systemic lupus erythematosus.
        J Clin Invest. 1981; 67: 1297-1304
        • Anderson CL
        Human IgG Fc receptors.
        Clin Immunol Immunopathol. 1989; 53: S63-S71
        • Rossi F
        • Sultan Y
        • Kazatchkine MD
        Anti-idiotypes against autoantibodies and alloantibodies to VIII:C (anti-haemophilic factor) are present in therapeutic polyspecific normal immunoglobulins.
        Clin Exp Immunol. 1988; 74: 311-316
        • Rossi F
        • Kazatchkine MD
        Antiidiotypes against autoantibodies in pooled normal human polyspecific Ig.
        J Immunol. 1989; 143: 4104-4109
        • Zanetti M
        • Bigazzi PE
        Anti-idiotypic immunity and autoimmunity. I. In vitro and in vivo effects of anti-idiotypic antibodies to spontaneously occurring autoantibodies to rat thyroglobulin.
        Eur J Immunol. 1981; 11: 187-195
        • Calder EA
        • Irvine WJ
        • Davidson NM
        • Wu F
        T, B, and K cells in autoimmune thyroid disease.
        Clin Exp Immunol. 1976; 25: 17
        • Amino N
        • Mori H
        • Iwatani Y
        • Asari S
        • Izumiguchi Y
        • Miyai K
        Peripheral K lymphocytes in autoimmune thyroid disease: decrease in graves' disease and increase in hashimoto's disease.
        J Clin Endocrinol Metab. 1982; 54: 587
        • Engelhard D
        • Waner JL
        • Kapoor N
        • Good RA
        Effect of intravenous immune globulin on natural killer cell activity: possible association with autoimmune neutropenia and idiopathic thrombocytopenia.
        J Pediatr. 1986; 108: 77-81
        • Abe T
        • Matsuda J
        • Kawasugr K
        Functional effects of immunoglobulin on platelets.
        in: Clinical use of intravenous immunoglobulins. Academic Press, London1986: 187-202
        • Duhem C
        • Dicato MA
        • Ries F
        Side effects of intravenous immune globulins.
        Clin Exp Immunol. 1994; 97: 79-83
        • Ochs HD
        • Buckley RH
        • Pirofsky B
        • et al.
        Safety and patient acceptability of intravenous immune globulin in 10% maltose.
        Lancet. 1980; 2: 1158-1159
        • Copelan EA
        • Strohm PL
        • Kennedy MS
        • Tutschka PJ
        Hemolysis following intravenous immune globulin therapy.
        Transfusion. 1986; 26: 410-412
        • Woodruff RK
        • Grigg AP
        • Firkin FC
        • Smith IL
        Fatal thrombotic events during treatment of autoimmune thrombocytopenia with intravenous immunoglobulin in elderly patients [letter].
        Lancet. 1986; 2: 217-218
        • Frame WD
        • Crawford RJ
        Thrombotic events after intravenous immunoglobulin [letter].
        Lancet. 1986; 2: 468
        • Sekul EA
        • Cupler EJ
        • Dalakas MC
        Aseptic meningitis associated with high-dose intravenous immunoglobulin therapy: frequency and risk factors.
        Ann Intern Med. 1994; 121: 259-262
        • Nayak AS
        • Knifer WT
        • Infante AJ
        Miscarriage induced during IV immunoglobulin infusion.
        J Allergy Clin Immunol. 1987; 79: 228
        • Centers for Disease Control
        Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus infection.
        MMWR Morb Mortal Wkly Rep. 1986; 35: 231-233
        • Wells MA
        • Wittek AE
        • Epstein JS
        • et al.
        Inactivation and partition of human T-cell lymphotropic virus, type III, during ethanol fractionation of plasma.
        Transfusion. 1986; 26: 210-213
        • Zuck TF
        • Preston MS
        • Tankersley DL
        • et al.
        More on partitioning and inactivation of AIDS virus in immune globulin preparations [letter].
        N Engl J Med. 1986; 314: 1454-1455
        • Wood CC
        • Williams AE
        • McNamara JC
        • Annunziata JA
        • Feorino PM
        • Conway CO
        Antibody against the human immunodeficiency virus in commercial gammaglobulin preparations.
        Ann Intern Med. 1986; 105: 536-538
        • Gocke DJ
        • Raska K
        • Pollack W
        • Schwartzer T
        HTLV-III antibody in commercial immunoglobulin [letter].
        Lancet. 1986; 1: 37-38
        • White WB
        • Ryan RW
        • Staley DD
        • Ballow M
        Passive transfer of antibodies to human T-cell lymphotropic virus type III in patients receiving high-dose intravenous immunoglobulin.
        JAMA. 1986; 255: 2602-2603
        • Schiff RI
        Transmission of viral infections through intravenous immune globulin.
        N Engl J Med. 1994; 331: 1649-1650
        • Centers for Disease Control and Prevention
        Outbreak of hepatitis C associated with intravenous immunoglobulin administration—United States, October 1993–June 1994.
        MMWR Morb Mortal Wkly Rep. 1994; 43: 505-509
        • Hein RH
        • McCue JP
        • Hink J
        Non-A, non-B hepatitis and intravenous immunoglobulin [letter].
        Lancet. 1985; 1: 404-405
        • Barnes R
        A case of fever in a pregnant woman by extensive purpuric effusion in the skin.
        BMJ. 1867; 2: 375
        • McMillan R
        • Tani P
        • Millard F
        • Berchtold P
        • Renshaw L
        • Woods VL
        Platelet-associated and plasma anti-glycoprotein autoantibodies in chronic ITP.
        Blood. 1987; 70: 1040-1045
        • Tani P
        • Berchtold P
        • McMillan R
        Autoantibodies in chronic ITP.
        Blut. 1989; 59: 44-46
        • Karpatkin S
        Autoimmune thrombocytopenic purpura.
        Blood. 1980; 56: 329
        • McMillan R
        Chronic idiopathic thrombocytopenic purpura.
        N Engl J Med. 1981; 304: 1135-1147
        • Kelton JG
        • Inwood MJ
        • Barr RM
        • et al.
        The prenatal prediction of thrombocytopenia in infants of mothers with clinically diagnosed immune thrombocytopenia.
        Am J Obstet Gynecol. 1982; 144: 449-454
      3. 3rd ed. Maternal-fetal medicine: principles and practice. WB Saunders, Philadelphia1994
        • Cines D
        • Dusak B
        • Tomaski B
        • Mennuti M
        • Schreiber A
        Immune thrombocytopenic purpura and pregnancy.
        N Engl J Med. 1982; 306: 826-831
        • Silver RM
        • Branch DW
        • Scott JR
        Maternal thrombocytopenia in pregnancy: time for a reassessment.
        Am J Obstet Gynecol. 1995; 173: 479-482
        • Imbach P
        • d'Apuzzo V
        • Hirt A
        • Rossi E
        • et al.
        High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood.
        Lancet. 1981; 1: 1228
        • Bussel JB
        • Kimberly RP
        • Inman RD
        • et al.
        Intravenous gammaglobulin treatment of chronic idiopathic thrombocytopenic purpura.
        Blood. 1983; 62: 480-486
        • Newland AC
        • Treleavin JG
        • Minchinton RM
        • Waters AH
        High-dose intravenous IgG in adults with autoimmune thrombocytopenia.
        Lancet. 1983; 1: 84-87
        • Imholz B
        • Imbach P
        • Baumgartner C
        • et al.
        Intravenous immunoglobulin for previously treated acute or for chronic idiopathic thrombocytopenic purpura in childhood: a prospective multicenter study.
        Blut. 1988; 56: 63-68
        • Carroll RR
        • Noyes WD
        • Kitchens CS
        High-dose intravenous immunoglobulin therapy in patients with immune thrombocytopenic purpura.
        JAMA. 1983; 249: 1748-1750
        • Tchernia G
        • Dreyfus M
        • Laurian Y
        • Derycke M
        • Mirica C
        • Kerbat G
        Management of immune thrombocytopenia in pregnancy: response to infusions of immunoglobulins.
        Am J Obstet Gynecol. 1984; 148: 225-226
        • Newland AC
        • Boots MA
        • Patterson KG
        Intravenous IgG for autoimmune thrombocytopenia in pregnancy.
        N Engl J Med. 1984; 310: 261-262
        • Wenske G
        • Gaedicke G
        • Heyes H
        Idiopathic thrombocytopenic purpura in pregnancy and neonatal period.
        Blut. 1984; 48: 377-382
        • Besa EC
        • MacNab MW
        • Solan AJ
        • Lapes MJ
        • Marfatia U
        High-dose intravenous IgG in the management of pregnancy in women with idiopathic thrombocytopenic purpura.
        Am J Hematol. 1985; 18: 373-379
        • Adderley RJ
        • Rogers PC
        • Shaw D
        • Wadsworth LD
        High-dose intravenous therapy with immune globulin before delivery for idiopathic thrombocytopenic purpura.
        Can Med Assoc J. 1984; 130: 894-896
        • Mizunuma H
        • Takahashi Y
        • Taguchi H
        • et al.
        A new approach to idiopathic thrombocytopenic purpura during pregnancy by high-dose immunoglobulin G infusion.
        Am J Obstet Gynecol. 1984; 148: 218-219
        • Morgenstern GR
        • Measday B
        • Hegde UM
        Autoimmune thrombocytopenia in pregnancy: a new approach to management.
        BMJ. 1983; 287: 584-585
        • Barton JC
        • Saleh MN
        • Stedman CM
        • Lobuglio AF
        Case report: immune thrombocytopenia: effects of maternal gamma globulin infusion on maternal and fetal serum, platelet, and monocyte IgG.
        Am J Med Sci. 1987; 293: 112-118
        • Gounder M
        • Baker D
        • Saletan S
        • et al.
        Intravenous gammaglobulin therapy in the management of a patient with idiopathic thrombocytopenic purpura and a warm erythrocyte panagglutinin during pregnancy.
        Obstet Gynecol. 1986; 67: 741-745
        • Lavery JP
        • Koontz WL
        • Liu YK
        • Howell R
        Immunologicthrombocytopenia in pregnancy; use of antenatal immunoglobulin therapy: case report and review.
        Obstet Gynecol. 1985; 66: 41s
        • Davidson BN
        • Rayburn WF
        • Bishop RC
        • Fleming WP
        • Beer AE
        Immunoglobulin therapy for autoimmune thrombocytopenia purpura during pregnancy.
        J Reprod Med. 1987; 32: 107-109
        • Bussel JB
        • Pham LC
        Intravenous treatment with gammaglobulin in adults with immune thrombocytopenic purpura: review of the literature.
        Vox Sang. 1987; 52: 206-211
        • Ballem PJ
        • Segal GM
        • Stratton JR
        • Gernsheimer T
        • Adamson JW
        • Slichter SJ
        Mechanisms of thrombocytopenia in chronic autoimmune thrombocytopenic purpura: evidence of both impaired platelet production and increased platelet clearance.
        J Clin Invest. 1987; 80: 33-40
        • Karpatkin S
        • Strick N
        • Siskind G
        Detection of splenic anti-platelet antibody synthesis in idiopathic autoimmune thrombocytopenic purpura.
        Br J Haematol. 1972; 23: 167-176
        • Imbach P
        • Jungi TW
        Possible mechanisms of intravenous immunoglobulin treatment in childhood idiopathic thrombocytopenic purpura.
        Blut. 1983; 46: 117-124
        • Blanchette VS
        • Kirby MA
        • Turner C
        Role of intravenous immunoglobulin G in autoimmune hematologic disorders.
        Semin Hematol. 1992; 29: 72-82
        • Clarkson SB
        • Bussel JB
        • Kimberly RP
        • Valinsky JE
        • Nachman RL
        • Unkeless JC
        Treatment of refractory immune thrombocytopenic purpura with an anti-Fc-receptor antibody.
        N Engl J Med. 1986; 314: 1236-1239
        • Bussel J
        • Kimberly R
        • Clarkson S
        • Nachman R
        • Valinsky J
        • Unkeless J
        Infusion of monoclonal anti-FcRIII in patients with refractory ITP.
        Neo-Adjuvant Chemother. 1988; 169: 883-887
        • McMillan R
        • Mason D
        • Tani P
        Suppressor cells in immune thrombocytopenic purpura.
        Blood. 1979; 54: 113A
        • Berchtold P
        • McMillan R
        Intravenous immunoglobulin: new aspects of mechanism of action in chronic ITP.
        in: Immunotherapy with intravenous immunoglobulins. Academic Press, London1991: 245-252
        • Schmidt B
        • Forester J
        Increased platelet associated IgG in a child on high dose gammaglobulin for idiopathic autoimmune thrombocytopenia purpura.
        Lancet. 1981; 2: 475
        • Christiaens GCML
        • Nieuwenhuis HK
        • Von Dem Borne AEGK
        • et al.
        Idiopathic thrombocytopenic purpura in pregnancy: a randomized trial on the effect of low dose corticosteroids on neonatal platelet count.
        Br J Obstet Gynaecol. 1990; 97: 893-898
        • Karpatkin M
        • Porges RF
        • Karpatkin S
        Platelet counts in infants of women with autoimmune thrombocytopenia: effect of steroid administration to the mother.
        N Engl J Med. 1981; 305: 936-939
        • Kaplan C
        • Daffos F
        • Forestier F
        • et al.
        Fetal platelet counts in thrombocytopenic pregnancy.
        Lancet. 1990; 336: 979-982
        • Cook RL
        • Miller RC
        • Katz VL
        • Cefalo RC
        Immune thrombocytopenic purpura in pregnancy: a reappraisal of management.
        Obstet Gynecol. 1991; 78: 578-583
        • Harris EN
        Syndrome of the black swan.
        Br J Rheumatol. 1987; 26: 324-326
        • Feinstein DI
        Lupus anticoagulant, thrombosis and fetal loss.
        N Engl J Med. 1985; 313: 1348-1350
        • Branch DW
        • Scott JR
        • Kochenour NK
        • Hershgold E
        Obstetric complications associated with the lupus anticoagulant.
        N Engl J Med. 1985; 313: 1322-1326
        • De Wolf F
        • Carreras LO
        • Moerman P
        • Vermylen J
        • Van Assche A
        • Renaer M
        Decidual vasculopathy and extensive placental infarction in a patient with repeated thromboembolic accidents, recurrent fetal loss and a lupus anticoagulant.
        Am J Obstet Gynecol. 1982; 142: 829-834
        • Lockshin MD
        • Qamar T
        • Druzin ML
        • Goei S
        Antibody to cardiolipin, lupus anticoagulant, and fetal death.
        J Rheumatol. 1987; 14: 259-262
        • Harris EN
        • Chan JK
        • Asherson RA
        • Aber VR
        • Gharavi AE
        • Hughes GR
        Thrombosis, recurrent fetal loss, and thrombocytopenia.
        Arch Intern Med. 1986; 146: 2153-2156
        • Branch DW
        • Silver RM
        • Blackwell JL
        • Reading JC
        • Scott JR
        Outcome of treated pregnancies in women with antiphospholipid syndrome: an update of the Utah experience.
        Obstet Gynecol. 1992; 80: 614-620
        • Cowchock FS
        • Reece EA
        • Balaban D
        • Branch DW
        • Plouffe L
        Repeated fetal losses associated with antiphospholipid antibodies: a collaborative randomized trial comparing prednisone with low-dose heparin treatment.
        Am J Obstet Gynecol. 1992; 166: 1318-1323
        • Lockshin MD
        • Druzin ML
        • Goei S
        • et al.
        Antibody to cardiolipin as a predictor of fetal distress or death in pregnant patients with systemic lupus erythematosus.
        N Engl J Med. 1985; 313: 152-156
        • Lubbe WF
        • Palmer SJ
        • Butler WS
        • Liggins GC
        Fetal survival after prednisone suppression of maternal lupus-anticoagulant.
        Lancet. 1983; 1: 1361-1363
        • Sanchez-Guerrero J
        • Alarcon-Segovia D
        Course of antiphospholipid antibodies in patients with primary antiphospholipid syndrome before, during and after pregnancy treated with low dose aspirin. relationship of antibody levels to outcome in 7 patients.
        J Rheumatol. 1992; 19: 1083-1088
        • Silveira LH
        • Hubble CL
        • Jara LJ
        • et al.
        Prevention of anticardiolipin antibody-related pregnancy losses with prednisone and aspirin.
        Am J Med. 1992; 93: 403-411
        • Lubbe WF
        • Butler WS
        • Palmer SJ
        • Liggins GC
        Lupus anticoagulant in pregnancy.
        Br J Obstet Gynaecol. 1984; 91: 357-363
        • Dahlman TC
        Osteoporotic fractures and the recurrence of thromboembolism during pregnancy and the puerperium in 184 women undergoing thromboprophylaxis with heparin.
        Am J Obstet Gynecol. 1993; 168: 1265-1270
        • McVerry BA
        • Spearing R
        • Smith A
        SLE anticoagulant: transient inhibition by high dose immunoglobulin infusions.
        Br J Haematol. 1985; 61: 579-580
        • Barbui T
        • Finazzi G
        • Falanga A
        • Cortelazzo S
        Intravenous gammaglobulin, antiphospholipid antibodies, and thrombocytopenia.
        Lancet. 1988; 1: 969
        • Carreras LO
        • Perez GN
        • Vega HR
        • Casavilla F
        Lupus anticoagulant and recurrent fetal loss: successful treatment with gammaglobulin.
        Lancet. 1988; 2: 393-394
        • Francois A
        • Freund M
        • Daffos F
        • Remy P
        • Aiach M
        • Jacquot C
        Repeated fetal losses and the lupus anticoagulant.
        Ann Intern Med. 1988; 109: 993-994
        • Scott JR
        • Branch DW
        • Kochenour NK
        • Ward K
        Intravenous immunoglobulin treatment of pregnant patients with recurrent pregnancy loss caused by antiphospholipid antibodies and Rh immunization.
        Am J Obstet Gynecol. 1988; 159: 1055-1056
        • Parke A
        • Maier D
        • Wilson D
        • Andreoli J
        • Ballow M
        Intravenous gamma-globulin, antiphospholipid antibodies, and pregnancy.
        Ann Intern Med. 1989; 110: 495-496
        • Wapner RJ
        • Cowchock FS
        • Shapiro SS
        Successful treatment in two women with antiphospholipid antibodies and refractory pregnancy losses with intravenous immunoglobulin infusions.
        Am J Obstet Gynecol. 1989; 161: 1271-1272
        • Kaaja R
        • Julkunen H
        • Ammala P
        • Palusuo T
        • Kurki P
        Intravenous immunoglobulin treatment of pregnant patients with recurrent pregnancy losses associated with antiphospholipid antibodies.
        Acta Obstet Gynecol Scand. 1993; 72: 63-66
        • Arnout J
        • Spitz B
        • Wittevrongel C
        • Vanrusselt M
        • Van Assche A
        • Vermylen J
        High-dose intravenous immunoglobulin treatment of a pregnant patient with antiphospholipid syndrome: immunological changes associated with a successful outcome.
        Thromb Haemost. 1994; 71: 741-747
        • Valensise H
        • Vaquero E
        • De Carolis C
        • et al.
        Normal fetal growth in women with antiphospholipid syndrome treated with high-dose intravenous immunoglobulin.
        Prenat Diagn. 1995; 15: 509-517
        • Branch DW
        • Dudley DJ
        • Mitchell MD
        • et al.
        Immunoglobulin G fractions from patients with antiphospholipid antibodies cause fetal death in balb/c mice: a model for autoimmune fetal loss.
        Am J Obstet Gynecol. 1990; 163: 210-216
        • Blank M
        • Cohen J
        • Toder V
        • Shoenfeld Y
        Induction of anti-phospholipid syndrome in naive mice with mouse lupus monoclonal and human polyclonal anti-cardiolipin antibodies.
        Proc Natl Acad Sci U S A. 1991; 88: 3069-3073
        • Bakimer R
        • Guilburd B
        • Zurgil N
        • Shoenfeld Y
        The effect of intravenous gammaglobulin on the induction of experimental antiphospholipid syndrome.
        Clin Immunol Immunopathol. 1993; 69: 97-102
        • Pierangeli SS
        • Barker JH
        • Stikovac D
        • et al.
        Effect of human IgG antiphospholipid antibodies on an in vivo thrombosis model in mice.
        Thromb Haemost. 1994; 71: 670-674
        • Ishii Y
        • Nagasawa K
        • Mayumi T
        • Niho Y
        Clinical importance of persistence of anticardiolipin antibodies in systemic lupus erythematosus.
        J Rheum Dis. 1990; 49: 387-390
        • Blachette VS
        • Chen L
        • Salomon de Friedberg Z
        • Hogan VA
        • Trudel E
        • Decary F
        Alloimmunization to the PLA1 platelet antigen: results of a prospective study.
        Br J Haematol. 1990; 74: 209-215
        • Mueller-Eckhardt C
        • Kiefel V
        • Grubert A
        • et al.
        348 cases of suspected neonatal alloimmune thrombocytopenia.
        Lancet. 1989; 1: 363-366
        • Reznikoff-Etivant MF
        Management of alloimmune neonatal and antenatal thrombocytopenia.
        Vox Sang. 1988; 55: 193-201
        • Schulman NR
        • Marder VJ
        • Hiller MC
        • Collier EM
        Platelet and leukocyte isoantigens and their antibodies: serologic, physiologic, and clinical studies.
        in: Progress in hematology. Grune & Stratton, New York1964: 222-304
        • Pearson HA
        • Schulman NR
        • Marder VJ
        • Cone Jr, TE
        Isoimmune neonatal thrombocytopenic purpura: clinical and therapeutic considerations.
        Blood. 1964; 23: 154-177
        • Bussel JB
        Neonatal alloimmune thrombocytopenia: a prospective case accumulation study [abstract].
        Pediatr Res. 1988; 23: 337A
        • Herman JH
        • Jumbelic MI
        • Ancona RJ
        • Kickler TS
        In utero cerebral hemorrhage in alloimmune thrombocytopenia.
        Am J Pediatr Hematol Oncol. 1986; 8: 312-317
        • Nicolini U
        • Tannirandorn Y
        • Gonzalez P
        • et al.
        Continuing controversy in alloimmune thrombocytopenia: fetal hyperimmunoglobulinemia fails to prevent thrombocytopenia.
        Am J Obstet Gynecol. 1990; 163: 1144-1146
        • Shulman NR
        • Jordan Jr, JV
        Platelet immunology.
        in: Hemostasis and thrombosis: basic principles and clinical practice. JB Lippincott, Philadelphia1982: 274-342
        • Muller JY
        • Patereau C
        • Reznikoff-Etievant MF
        • Kaplan C
        • Simonney N
        Les thrombopenies neonatules alloimmunes.
        Rev Fr Trans Immunohematol. 1985; 28: 625-641
        • Bussel JB
        • Berkowitz RL
        • McFarland JG
        • Lynch L
        • Chitkara U
        Antenatal treatment of neonatal alloimmune thrombocytopenia.
        N Engl J Med. 1988; 319: 1374-1378
        • Daffos F
        • Forestier F
        • Kaplan C
        Prenatal treatment of fetal alloimmune thrombocytopenia.
        J Pediatr. 1980; 97: 695-696
        • Kaplan C
        • Daffos F
        • Forestier F
        • et al.
        Management of alloimmune thrombocytopenia: antenatal diagnosis and in utero transfusion of maternal platelets.
        Blood. 1988; 72: 340-343
        • Murphy MF
        • Pullon HWH
        • Metcalfe P
        • et al.
        Management of fetal alloimmune thrombocytopenia by weekly in utero platelet transfusions.
        Vox Sang. 1990; 58: 45
        • Bussel JB
        • McFarland JG
        • Berkowitz RL
        Antenatal management of fetal alloimmune and autoimmune thrombocytopenia.
        Trans Med Rev. 1990; 4: 149-162
        • Lynch L
        • Bussel JB
        • McFarland JG
        • Chitkara U
        • Berkowitz RL
        Antenatal treatment of alloimmune thrombocytopenia.
        Obstet Gynecol. 1992; 80: 67-71
        • Wenstrom KD
        • Weiner CP
        • Williamson RA
        Antenatal treatment of fetal alloimmune thrombocytopenia.
        Obstet Gynecol. 1992; 80: 433-435
        • Mir N
        • Samson D
        • House MJ
        • Kovar IZ
        Failure of antenatal high dose immunoglobulin to improve fetal platelet count in neonatal allo-immune thrombocytopenia.
        Vox Sang. 1988; 55: 188-189
        • Marzuseh K
        • Schnaidt M
        • Dietl J
        • Weist E
        • Hofstaetter C
        • Golz R
        High-dose immunoglobulin in the antenatal treatment of neonatal alloimmune thrombocytopenia: a case report and review.
        Br J Obstet Gynecol. 1992; 99: 260-262
        • Bussel JB
        • Berkowitz RL
        • Lynch L
        • Lesser ML
        • Paidas MJ
        • Huang CL
        • et al.
        Antenatal management of alloimmune thrombocytopenia with intravenous gamma globulin: a randomized trial of the addition of low-dose steroid to intraenous gamma globulin.
        Am J Obstet Gynecol. 1996; 174: 1414-1423
        • Giovangrandi Y
        • Daffos F
        • Kaplan C
        Very early intracranial hemorrhage in alloimmune thrombocytopenia [letter].
        Lancet. 1990; 2: 310
        • Burrows RF
        • Kelton JG
        Perinatal thrombocytopenia.
        in: Volume 22: clinics in perinatology. WB Saunders, Philadelphia1995: 797-798
        • Berlin G
        • Selbing A
        • Ryden G
        Rhesus haemolytic disease treated with high dose intravenous immunoglobulin.
        Lancet. 1985; 1: 1153
        • De La Camara C
        • Arrieta R
        • Gonzalez A
        • Iglesias E
        • Omenara F
        High-dose intravenous immunoglobulin as the sole prenatal treatment for severe Rh immunization.
        N Engl J Med. 1988; 318: 519-520
        • Chitkara V
        • Bussel J
        • Alvarez M
        • Lynch L
        • Meisel R
        • Berkowitz R
        High-dose intravenous gamma globulin: does it have a role in the treatment of severe erythroblastosis fetalis.
        Obstet Gynecol. 1990; 76: 703
        • Margulies M
        • Voto LS
        • Mathet E
        • Margulies M
        High-dose intravenous IgG for the treatment of severe rhesus alloimmunization.
        Vox Sang. 1991; 61: 181-189
      4. Intravenous immunoglobulin: prevention and treatment of disease. NIH Consensus Conference.
        JAMA. 1990; 264: 3189-3193
        • Haque KN
        • Zaidi MH
        • Haque SK
        • Bahakim H
        • El-Hazmi H
        • El-Swailam M
        Intravenous immunoglobulin for prevention of sepsis in preterm and low birthweight infants.
        Pediatr Infect Dis. 1986; 5: 622-625
        • Clapp DW
        • Kliegman RM
        • Baley JE
        • et al.
        Use of intravenously administered immune globulin to prevent nosocomial sepsis in low birth weight infants: report of a pilot study.
        J Pediatr. 1989; 115: 973-978
        • Bussel JB
        • La Gamma EF
        • Giuliano M
        Intravenous gamma-globulin prophylaxis of late sepsis in very low birth weight infants: a randomized placebo controlled trial.
        Pediatr Res. 1989; 29: 471
        • Morell A
        • Sidiroupoulos D
        • Hermann U
        • et al.
        IgG subclasses and antibodies to group B streptococci in preterm neonates after intravenous infusion of immunoglobulin to the mothers.
        Pediatr Infect Dis. 1986; 5: 5195-5197
        • Von Muralt G
        • Sidiroupoulous D
        Prenatal and postnatal prophylaxis of infections in preterm neonates.
        Pediatr Infect Dis. 1988; 7: S72-S78
        • Kaaja R
        • Julkunen H
        • Ammala P
        • Teppo A
        • Kurki P
        Congenital heart block: successful prophylactic treatment with intravenous gamma globulin and corticosteroid therapy.
        Am J Obstet Gynecol. 1991; 165: 1333-1334
        • Finazzi G
        • Bellavita P
        • Falanga A
        • Viero P
        • Barbui T
        Inefficacy of intravenous immunoglobulin in patients with low-risk thrombotic thrombocytopenic purpura/hemolytic uremic syndrome.
        Am J Hematol. 1992; 41: 165-169