Potential role of intravenous immunoglobulin in the management of peripartum maternal thrombocytopenia due to various causes.

Severe maternal thrombocytopenia resulting in hemorrhage is often associated with high mortality. Three cases of severe maternal thrombocytopenia in association with heparin-induced thrombocytopenia (HIT), HELLP syndrome, and systemic lupus erythematosus (SLE) were successfully managed using intravenous immunoglobulin (IVIG). IVIG can reduce the severity of thrombocytopenia and hemolysis, stabilize lupus activity, prevent peripartum hemorrhage, and shorten hospitalization, but it may induce reversible interstitial nephritis and membranous glomerulonephritis. IVIG may be beneficial in the management of severe peripartum maternal thrombocytopenia in association with HIT, HELLP syndrome, and SLE.