Collinet P, Subtil D, Puech F, Vaast P
Clinique de Gynécologie, Obstétrique et Néonatalogie, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire de Lille, Lille, France.
Obstet Gynecol. 2002 Nov;100(5 Pt 2):1102-5. doi: 10.1016/s0029-7844(02)02143-9.
Repeated plasmapheresis was used to prevent fetal death from severe anti-Kell alloimmunization until intrauterine transfusions were feasible.
Repeated maternal plasma exchanges (N = 40) beginning at 7 weeks' gestation were used to treat severe anti-Kell alloimmunization. Ultrasound examination at 19 weeks' gestation revealed diffuse hydrops in this fetus (umbilical venous hemoglobin, 1.2 g/dL), which then required nine intrauterine transfusions through 34 weeks. A healthy 3840-g girl was delivered by cesarean delivery at 36 weeks. Despite aplastic anemia during the first 3 months of life, she is healthy and has no observable abnormalities at age 8.
A highly aggressive course of plasmapheresis and intrauterine transfusions can successfully treat fetal anemia caused by anti-Kell alloimmunization even when fetal hemoglobin is extremely low.
在可行宫内输血之前，反复进行血浆置换用于预防因严重抗 Kell 同种免疫导致的胎儿死亡。
从妊娠 7 周开始进行反复的母体血浆置换（共 40 次）以治疗严重的抗 Kell 同种免疫。妊娠 19 周时超声检查发现该胎儿有弥漫性水肿（脐静脉血红蛋白为 1.2 g/dL），随后在孕 34 周前需要进行 9 次宫内输血。孕 36 周时通过剖宫产分娩出一名健康的 3840 克女婴。尽管在出生后的前 3 个月患有再生障碍性贫血，但她目前健康，8 岁时未观察到异常。
即使胎儿血红蛋白极低，但积极的血浆置换和宫内输血疗程能够成功治疗由抗 Kell 同种免疫引起的胎儿贫血。
