Rappaport Valerie J, Velazquez Maria, Williams Kayon
Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, University of New Mexico Health Sciences Center, 211 Lomas Blvd NE, ACC-4, Albuquerque, NM 87131, USA.
Obstet Gynecol Clin North Am. 2004 Jun;31(2):287-317, vi. doi: 10.1016/j.ogc.2004.03.006.
Hemoglobinopathies represent a unique set of genetic disorders. Formerly, many affected individuals did not survive to childbearing age. Affected women now commonly reach childbearing age and desire pregnancy. Successful pregnancy is possible in many cases with carefully coordinated obstetric and medical management. Genetic screening and prenatal diagnosis is an important aspect of prenatal care in these disorders. DNA mutation analysis offers rapid and accurate fetal diagnosis. Pregnancy also offers a unique situation in that cord blood has become a valuable source of stem cells for transplant. This allows the potential role of the unaffected fetus as a donor for affected siblings. In addition, it was proposed that the fetus may be able to act as a donor of stem cells for an affected mother. Despite current screening recommendations,many couples are not aware that they are carriers; it is common for a child to be born with an unexpected, serious hemoglobinopathies. For this reason, newborn screening programs have been introduced in most high-risk areas. Early diagnosis can facilitate implementation of proper preventive health measures, education of the parents regarding their carrier status, and provide the child with ongoing comprehensive care.
血红蛋白病是一组独特的遗传性疾病。以前,许多患者活不到生育年龄。现在,患病女性通常能达到生育年龄并渴望怀孕。通过精心协调的产科和医疗管理,许多情况下成功怀孕是可能的。基因筛查和产前诊断是这些疾病产前护理的重要方面。DNA突变分析可实现快速准确的胎儿诊断。怀孕还带来了一种独特的情况,即脐带血已成为移植用干细胞的宝贵来源。这使得未受影响的胎儿有可能成为受影响同胞的干细胞供体。此外,有人提出胎儿可能能够作为干细胞供体为患病母亲提供帮助。尽管有当前的筛查建议,但许多夫妇并不知道自己是携带者;孩子出生时患有意外的严重血红蛋白病很常见。因此,大多数高危地区都已实施新生儿筛查项目。早期诊断有助于实施适当的预防保健措施,让父母了解自己的携带者状态,并为孩子提供持续的全面护理。