大量胎母输血的围生期诊治策略  

Treatment Strategies of Massive Fetomaternal Hemorrhage During Perinatal Stage

作　　者：张颖[1] 王子莲[1] 蔡坚[1] 杨建波[1] 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080

出　　处：《临床医学工程》2013年第9期1104-1105,共2页Clinical Medicine & Engineering

基　　金：广省科学技术厅基金(编号:2012B031800384)

摘　　要：目的探讨大量胎母输血的围生期诊断与治疗策略。方法收集我院从2011年1月至2013年5月共5例大量母胎输血的病例,对其临床表现及处理进行回顾性分析。结果 5例大量胎母输血仅2例产前确诊。产前表现包括胎动减少或消失,胎儿水肿及胎监曲线异常。结论大量胎母输血发病隐匿,对于胎儿可能是致死性的,对可疑病例应询问病史,结合胎监、多普勒超声检查及Kleihauer-Betke试验,可尽早诊断,及时进行宫内输血或剖宫产结束妊娠,可提高围产儿的存活率,改善预后。Objective To explore the treatment strategies of massive fetomaternal hemorrhage during perinatal stage.Methods Five cases of massive fetomaternal hemorrhage were collected in our hospital from January 2011 to May 2013.The clinical manifestation and treatment were analyzed retrospectively.Results Only 2 cases in the 5 cases were diagnosed prenatally.Prenatal manifestation included decrease or disappearance of fetal movement,fetal hydrops and electronic fetal heart rate pattern abnormalities.Kleihauer-Betke test was used for prenatal diagnosis and fetal blood loss estimation.Conclusions None of the available tests can provide information regarding the timing of massive fetomaternal hemorrhage onset,but it may be fatal to the fetus.Detailed history analysis,electronic fetal heart rate monitoring,doppler ultrasound scan and Kleihauer-Betke test can help to early diagnosis.Intrauterine transfusion or cesarean section in time can improve the pregnancy outcome.

关 键 词：胎儿母体输血综合征 胎儿 贫血 

分 类 号：R714[医药卫生—妇产科学]