Steyn D W, Pattinson R C, Odendaal H J
Department of Obstetrics and Gynaecology, Tygerberg Hospital, Parowvallei, CP.
S Afr Med J. 1992 Nov;82(5):321-4.
To determine the role of amniocentesis in the management of severe rhesus (Rh), incompatibility.
A 10-year retrospective descriptive study.
Department of Obstetrics and Gynaecology, Tygerberg Hospital, CP.
111 pregnancies complicated by severe Rh incompatibility where management had been based on results obtained from amniocentesis.
Neonatal haemoglobin values, neonatal survival and short-term morbidity as compared with the position on the Liley chart after amniocentesis immediately before delivery.
Average neonatal haemoglobin value decreased for the group in the lower zone through the midzone to the upper zone, but wide scattering of individual values between the various zones occurred. Perinatal mortality rate was 93/1,000 deliveries with Rh-related deaths occurring only in the upper midzone and upper zones. One death and 7 cases of morbidity occurred after acting on misleading information from the Liley curve.
Amniotic fluid bilirubin values are at best an indirect evaluation of the state of disease. No serious complications are likely to occur when these values fall in the lower or lower mid-zones of the Liley chart. When bilirubin values fall in the upper midzone or upper zone, cordocentesis should be performed to prevent overreaction or to perform an intra-uterine transfusion.
确定羊膜腔穿刺术在严重恒河猴（Rh）血型不合管理中的作用。
一项为期10年的回顾性描述性研究。
开普敦泰格伯格医院妇产科。
111例因严重Rh血型不合而妊娠的病例，其管理基于羊膜腔穿刺术获得的结果。
与分娩前即刻羊膜腔穿刺术后在利莱图表上的位置相比，新生儿血红蛋白值、新生儿存活率和短期发病率。
从较低区域到中间区域再到较高区域，该组新生儿平均血红蛋白值下降，但各区域间个体值分布较分散。围产儿死亡率为每1000例分娩93例，与Rh相关的死亡仅发生在中间较高区域和较高区域。根据利莱曲线的误导性信息采取行动后，出现1例死亡和7例发病情况。
羊水胆红素值充其量只是对疾病状态的间接评估。当这些值落在利莱图表的较低或中间较低区域时，不太可能发生严重并发症。当胆红素值落在中间较高区域或较高区域时，应进行脐血穿刺术以防止过度反应或进行宫内输血。
