Murotsuki J, Okamura K, Iwamoto M, Kosuge S, Kimura Y, Kobayashi M, Takeyama Y, Yano M, Yajima A
Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai.
Nihon Sanka Fujinka Gakkai Zasshi. 1992 Jun;44(6):638-42.
Reference ranges for four hematological parameters--hemoglobin, hematocrit, white blood cell and platelet count--in each gestation were established from values for fetal blood samples obtained by cordocentesis from 72 pregnancies at 16-39 weeks gestation. These 72 fetuses turned out as normal or single malformations which should not affect fetal hematological values. Significant correlations were observed between hemoglobin, hematocrit and platelet counts and the number of weeks of gestation. No correlation was found between the white blood cell count and gestational age. Fetal anemia (hematocrit was below the lower limit of the 95% confidence interval) was found in 18 (7%) of all the fetuses that underwent cordocentesis, including nonimmune hydrops fetalis (8 cases), Rh isoimmunization (4 cases), twin-to-twin transfusion syndrome (3 cases), trisomy 18 (2 cases) and autoimmune thrombocytopenia (1 case). Of 26 hydropic fetuses, 8 (31%) were anemic. The prognosis of those fetuses depended on either the gestational age or the severity of the fetal anemia. Our results are useful in diagnosing fetal hematological disorders and to make decisions for fetal therapy.
通过对孕16 - 39周的72例孕妇进行脐血穿刺获取胎儿血样，确定了各孕周四种血液学参数（血红蛋白、血细胞比容、白细胞计数和血小板计数）的参考范围。这72例胎儿均为正常或单一畸形，不应影响胎儿血液学指标。观察到血红蛋白、血细胞比容和血小板计数与孕周之间存在显著相关性。白细胞计数与胎龄之间未发现相关性。在所有接受脐血穿刺的胎儿中，18例（7%）出现胎儿贫血（血细胞比容低于95%置信区间下限），包括非免疫性胎儿水肿（8例）、Rh血型免疫（4例）、双胎输血综合征（3例）、18三体综合征（2例）和自身免疫性血小板减少症（1例）。在26例水肿胎儿中，8例（31%）贫血。这些胎儿的预后取决于孕周或胎儿贫血的严重程度。我们的结果有助于诊断胎儿血液学疾病并为胎儿治疗决策提供依据。
