母儿Rh血型不合孕期监测研究进展  

Research progress of the monitoring pregnant women with maternal and infant Rh blood group incompatibility during pregnancy

作　　者：谢梦潇 王欣[1] XIE Mengxiao;WANG Xin(Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026)

机构地区：[1]首都医科大学附属北京妇产医院,100026

出　　处：《中国计划生育学杂志》2021年第7期1532-1538,共7页Chinese Journal of Family Planning

摘　　要：母儿血型不合严重威胁胎儿及新生儿的安全,其主要发病机制为胎儿血型和母体相异,在各血型系统中,以母儿Rh血型不合病情最为严重。因此对Rh阴性孕妇孕期监测及新生儿Rh血型的出生前诊断对母儿Rh血型不合及新生儿溶血病的预防和治疗具有重要意义。本文综述目前国内外母儿Rh血型不合的常用孕期监测方法,包括超声监测、大脑中动脉血流监测、孕期血型抗体监测、羊水胆红素检查等手段优的缺点。出生前胎儿血型测定,包括有创及无创两种方法。目前无创性母亲外周血高通量测序确定胎儿Rh血型在国外已普遍开展,指导Rh阴性孕妇孕期管理。对于存在母儿血型不合风险者加强管理,应用预防性治疗。避免不存在母儿血型不合孕妇的不必要监测及预防性治疗,减轻精神及经济负担。对发生母儿血型不合者,治疗方案包括出生前宫内输血、出生后光疗及换血疗法。在充分准备情况下,选择适宜分娩时机,联系血液科及新生儿科,多学科合作,才能保障母儿安全及新生儿预后良好。Maternal and infant blood group incompatibility seriously threats the safety of fetuses and newborns,which main pathogenesis is the difference between fetal blood group and maternal blood group.Among all blood group incompatibility,maternal and infant Rh blood group incompatibility is the most serious.Therefore,the monitoring of the pregnant women with Rh negative blood type during pregnancy and the diagnosis of fetal Rh blood group have great significance for preventing and treating maternal and infant Rh blood group incompatibility and the neonatal hemolytic disease.This paper reviews the domestic and overseas articles about the commonly monitoring methods during pregnancy for maternal and infant Rh blood group incompatibility,which included the advantages and disadvantages of ultrasound monitoring,blood flow monitoring of middle cerebral artery,blood group antibody monitoring during pregnancy,and amniotic fluid bilirubin testing,etc.Prenatal fetal blood type determination includes invasive and non-invasive methods.At present,non-invasive maternal peripheral blood high throughput sequencing to determine fetal Rh blood group has been widely carried out abroad to guide the management of the pregnant women with Rh negative blood type during pregnancy.The management of the pregnant women with maternal and infant blood group incompatibility should be strengthened,and the preventive treatment for them should be applied.Avoid unnecessary monitoring and preventive treatment for the pregnant women without maternal and infant blood group incompatibility for reducing their mental and economic burden.Treatment options for the pregnant women with maternal and infant blood group incompatibility include prenatal fetal intrauterine blood transfusion,and postnatal phototherapy and blood exchange therapy of newborns.Under the condition of full preparation,selecting the appropriate delivery time,contacting with hematology department and neonatology department,and interdisciplinary cooperation can guarantee the safety of mother an

关 键 词：母儿血型不合 RH阴性血型 Rh血型不合监测 Rh血型不合治疗 

分 类 号：R71[医药卫生—妇产科学]