Management

Of bleeding neonate: transfuse platelets -ve for Ag (usually HPA-1a -ve); use random donor platelets in an emergency. Maternal platelets (irradiated) are a good source. Repeat platelet transfusion PRN. IVIg as for

ITP can be used in exceptional cases (response within days). Close observation (ICH is potentially lethal—screen using USS).

Of subsequent pregnancies: cordocentesis in utero at ~24 weeks; take 1-3mL blood for platelet count and phenotype. If affected, treatment needs to be started immediately.

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