Semmekrot B A, de Man A J, Boekkooi P F, van Dijk B A
Afd. Kindergeneeskunde, Academisch Ziekenhuis, Nijmegen.
Ned Tijdschr Geneeskd. 1999 Jul 10;143(28):1449-52.
During pregnancy irregular blood group antibodies, originating either from earlier pregnancies or from blood transfusions, may severely jeopardize both mother and child. Three patients are described with pregnancy-associated blood group incompatibility. In one case of Kell antagonism a previous child had reportedly died of cot death, but in retrospect it had most probably suffered from erythroblastosis fetalis as a result of anti Kell antibodies. In the second case, a twin pregnancy, the diagnosis of neonatal haemolytic anaemia on the basis of blood group incompatibility with a very rare antibody (anti-Kpb) had been established in the previous child. No precautions had been taken during this pregnancy, putting both mother and children at risk. All three children recovered, the twins after repeated transfusion of Kpb-free erythrocytes. The described cases emphasize the importance of being informed about the presence of antibodies during pregnancy. Such information can only be obtained by assessing the antibody status during pregnancy. In the Netherlands, the screening of all pregnant women for the presence of irregular antibodies was introduced last year.
孕期中，源于既往妊娠或输血产生的不规则血型抗体可能会严重危及母婴。本文描述了3例与妊娠相关的血型不相容病例。在1例凯尔血型抗体拮抗的病例中，据报道前一个孩子死于婴儿猝死综合征，但回顾来看，其很可能是因抗凯尔抗体而患胎儿成红细胞增多症。在第2例双胎妊娠中，前一个孩子已确诊为基于与一种非常罕见抗体（抗Kpb）血型不相容的新生儿溶血性贫血。此次妊娠期间未采取任何预防措施，使母婴均处于危险之中。所有3个孩子均康复，双胞胎在反复输注不含Kpb的红细胞后痊愈。所述病例强调了孕期了解抗体存在情况的重要性。此类信息只能通过孕期评估抗体状态来获取。荷兰去年已开始对所有孕妇进行不规则抗体筛查。
