With an overall risk of death of the fetus due to the repeated procedures of about 3% (17 deaths out of 485 pregnancies).In addition, given the short life span of transfused platelets, transfusions are needed regularly, increasing the overall risk of death of the baby. If intrauterine platelet transfusions are performed, they are generally repeated weekly (platelet lifespan after transfusion is approximately 8 to 10 days). Platelets administered to the fetus must be negative for the culprit antigen (often HPA-1a, as stated above). Many blood suppliers (such as American Red Cross; NHS Blood and Transplant; United Blood Services) have identified HPA-1a and 5b negative donors. An alternative donor is a mother who is, of course, negative for the culprit antigen. However, she must meet general criteria for donation and platelets received from the mother must be washed to remove the offending alloantibody and irradiated to reduce the risk of graft-versus-host disease. If platelet transfusions are needed urgently, incompatible platelets may be used, with the understanding that they may be less effective and that the administration of any blood product carries risk.Any administered cellular blood products must be irradiated to reduce the risk of graft-versus-host disease in the fetus. Additionally, all administered blood products should be CMV reduced-risk (CMV seronegative and leukoreduced are considered essentially equivalent for the purposes of CMV risk reduction). Non-invasive management
The use of Intravenous immunoglobulin (IVIG) during pregnancy and immediately after birth has been shown to help reduce or alleviate the effects of NAIT in infants and reduce the severity of thrombocytopenia.
If the delivery has been planned then antigen negative platelets should be available in case the infants platelet count is low on a cord blood sample. After birth
The most rapidly effective treatment in infants with severe hemorrhage and/or a very low platelet count (<30,000  μL−1) is the transfusion of compatible platelets (i.e. platelets from a donor who, like the mother, lacks the causative antigen). If  antigen negative platelets are unavailable, then standard neonatal platelet transfusions should be given until antigen negative platelets become available. If a platelet transfusion is not available immediately then the infant can be given IVIG (1g/kg) however, this will have no effect on the platelet count before 24 to 72 hours.A platelet transfusion is required immediately if there is severe or life-threatening bleeding. If life-threatening bleeding occurs, for example an intracranial hemorrhage, then the platelet count needs to be increased to decrease the risk of further bleeding (> 100,000  μL−1).Any infant with suspected NAIT should have an ultrasound of the head within the first 24 hours after birth to make sure that there is no evidence of an intracranial hemorrhage.If the infant has a platelet count >30,000  μL−1 and no evidence of bleeding, then the baby can be monitored with blood counts until the blood counts return to normal, without the need for any additional treatment. In the past, infusions of IVIG (1 g/kg/day for two days) have been given to the infant and have been shown to rapidly increase the platelet count.