PMID- 33386311
OWN - NLM
STAT- MEDLINE
DCOM- 20211102
LR  - 20211102
IS  - 1526-9906 (Electronic)
IS  - 1526-9906 (Linking)
VI  - 22
IP  - 1
DP  - 2021 Jan
TI  - Update on the Use of Intravenous Immunoglobulin in Pregnancy.
PG  - e7-e24
LID - 10.1542/neo.22-1-e7 [doi]
AB  - Intravenous immunoglobulin (IVIG) was first administered to humans in the 1980s. 
      The mechanism of action of IVIG is still a subject of debate but the 
      pharmacokinetics have been well characterized, albeit outside of pregnancy. IVIG 
      has been used in pregnancy to treat several nonobstetrical and 
      obstetrical-related conditions. However, current evidence suggests that IVIG use 
      during pregnancy can be recommended for 1) in utero diagnosis of neonatal 
      alloimmune thrombocytopenia; 2) gestational alloimmune liver disease; 3) 
      hemolytic disease of the fetus and newborn for early-onset severe intrauterine 
      disease; 4) antiphospholipid syndrome (APS) when refractory to or contraindicated 
      to standard treatment, or in catastrophic antiphospholipid syndrome; and 5) 
      immune thrombocytopenia when standard treatment is ineffective or rapid increase 
      of platelet counts is needed. All recommendations are based on case series and 
      cohort studies without randomized trials usually because of the rare prevalence 
      of the conditions, the high incidence of adverse outcomes if left untreated, and 
      ethical concerns. In contrast, IVIG therapy cannot be recommended for recurrent 
      pregnancy loss, and the use of IVIG in subgroups of those with recurrent 
      pregnancy loss requires further investigations. For non-obstetrical-related 
      conditions, we recommend using IVIG as indicated for nonpregnant patients. In 
      conclusion, the use of IVIG during pregnancy is an effective treatment in some 
      obstetrical-related conditions with rare serious maternal side effects. However, 
      the precise mechanisms of action and the long-term immunologic effects on the 
      fetus and neonate are poorly understood and merit further investigations.
CI  - Copyright (c) 2021 by the American Academy of Pediatrics.
FAU - D'Mello, Rahul J
AU  - D'Mello RJ
AD  - Department of Obstetrics and Gynecology, Detroit Medical Center, Detroit, MI.
FAU - Hsu, Chaur-Dong
AU  - Hsu CD
AD  - Department of Obstetrics and Gynecology and.
AD  - Department of Physiology, Wayne State University School of Medicine, Detroit, MI.
FAU - Chaiworapongsa, Puangphaka
AU  - Chaiworapongsa P
AD  - Department of Pharmacy, Henry Ford Hospital, Detroit, MI.
FAU - Chaiworapongsa, Tinnakorn
AU  - Chaiworapongsa T
AD  - Department of Obstetrics and Gynecology and.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neoreviews
JT  - NeoReviews
JID - 101085360
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Antiphospholipid Syndrome
MH  - Female
MH  - Fetal Diseases
MH  - Humans
MH  - *Immunoglobulins, Intravenous/therapeutic use
MH  - Infant, Newborn
MH  - Pregnancy
MH  - Purpura, Thrombocytopenic, Idiopathic
EDAT- 2021/01/03 06:00
MHDA- 2021/11/03 06:00
CRDT- 2021/01/02 05:16
PHST- 2021/01/02 05:16 [entrez]
PHST- 2021/01/03 06:00 [pubmed]
PHST- 2021/11/03 06:00 [medline]
AID - 22/1/e7 [pii]
AID - 10.1542/neo.22-1-e7 [doi]
PST - ppublish
SO  - Neoreviews. 2021 Jan;22(1):e7-e24. doi: 10.1542/neo.22-1-e7.