Brossard Y, Sender A, Cartron J P, Huchet J, Pinon F, Blot P, David G
Centre d'Hémobiologie Périnatale (CHP), 53 Boulevard Diderot-75570 Paris.
Bull Acad Natl Med. 2001;185(2):329-36.
Anti-D prophylaxis is currently applied in France after birth of an RhD positive infant, after interruption of pregnancy and after some antenatal immunizing events (amniocentesis...). However this program does not cover all the prenatal exposures to fetal RhD antigen, and maternal Rh immunization continues to occur. DNA RhD genotyping of the fetus is now reliably performed on amniotic fluid, and pre diagnostic studies on fetal DNA extracted from maternal plasma are promising. The widespread use of fetal RhD genotyping on maternal blood would allow the antenatal administration of Rh immunoglobuline in all Rh negative patients bearing an Rh positive fetus, insofar as it would preclude exposing the other Rh negative patients to the above plasma derived and rather expensive blood product.
目前,法国在RhD阳性婴儿出生后、妊娠终止后以及一些产前免疫事件(如羊膜穿刺术等)后应用抗D预防措施。然而,该计划并未涵盖所有产前胎儿RhD抗原暴露情况,母亲的Rh免疫仍有发生。目前已能可靠地对羊水进行胎儿RhD基因分型,且从母体血浆中提取胎儿DNA的诊断前研究也很有前景。若能在孕妇血液中广泛开展胎儿RhD基因分型,那么对于所有怀有Rh阳性胎儿的Rh阴性患者都可进行产前Rh免疫球蛋白注射,因为这样可以避免让其他Rh阴性患者接触上述源自血浆且较为昂贵的血液制品。