高抗-D效价孕产妇产前管理及新生儿救治  

Prenatal management of pregnant women with high anti-D titer and treatment of their newborns

作　　者：凤婧[1] 袁佳 王海娟[1] 赵虹[1] 朱凯[1] 陈剑[1] FENG Jing;YUAN Jia;WANG Haijuan;ZHAO Hong;ZHU Kai;CHEN Jian(Key Laboratory of Birth Defects and Related Diseases of Women and Chidren( Sichuan University),Ministry of Education. Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院检验科出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《中国输血杂志》2019年第2期171-174,共4页Chinese Journal of Blood Transfusion

摘　　要：目的通过对14例抗-D效价≥128孕妇(其中1例为双胎妊娠)的孕期临床干预与产后新生儿治疗的分析,总结及分享本院监测、治疗母亲高抗-D效价致新生儿溶血病的方法经验。方法分析总结2013年1月—2017年6月到本院产科门诊就诊的RhD阴性且抗-D效价≥128的孕妇共14例,建卡后均行抗-D效价监测、胎监、MCA-PSV,S/D,并依据检测结果确定终止妊娠时机。新生儿娩出后,立即送脐血检测新生儿溶血病3项试验及血常规、肝功能,结合临床表现和实验室检测结果,给予新生儿溶血病的相关治疗。结果 14例高抗-D效价母亲生产的15例新生儿出生后均发生HDFN,经积极治疗后,均预后良好,未发生胆红素脑病及其它不良后果。结论本院现行的HDFN监测和救治策略,使高抗-D效价母亲生产的重度HDFN患儿得到成功救治,为此类患者的临床管理提供了良好的经验,值得借鉴。Objective Through analysis of clinical intervention and treatment of postpartum newborn in 14 pregnant women with anti-D titer≥128(including 1 gemellary pregnancy), we intended to summarize and share our experience in monitoring and curing hemolytic disease of newborn(HDFN) caused by maternal high anti-D titer.Methods Fourteen cases of pregnant women with RhD negative and anti-D titers≥128, registered in the outpatient department of our hospital from January 2013 to June 2017, were studied retrospectively. Anti-D potency monitoring and fetal monitoring of pregnant women were performed;maternal MCA-PSV and S/D were testd. The time of termination of pregnancy was depended on the monitor results as described above. After the delivery of the newborn, the cord blood was sent immediately to detect HDFN.The treatment of HDFN was carried out based on the clinical manifestations and laboratory test results.Results All 15 newborns delivered by14 high anti-D titer mothers were diagnosed with HDFN and acquired good prognosis after treatment.Conclusion The ongoing prenatal management of pregnant women with high anti-D titer contributes to the successful treatment of severe HDFN newborns, which may provides some experiences for clinical management of such patients.

关 键 词：RHD阴性 抗体效价 新生儿溶血病 输血 换血 

分 类 号：R457.1[医药卫生—治疗学] R556.63[医药卫生—临床医学]