母体循环中持续存在胎儿血红蛋白会使胎儿-母体出血的诊断复杂化。
Persistent fetal hemoglobin in maternal circulation complicating the diagnosis of fetomaternal hemorrhage.
作者信息
Kush Michelle L, Muench Michael V, Harman Christopher R, Baschat Ahmet A
机构信息
Center for Advanced Fetal Care, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland, Baltimore 21201, USA.
出版信息
Obstet Gynecol. 2005 Apr;105(4):872-4. doi: 10.1097/01.AOG.0000141646.58884.09.
BACKGROUND
Transplacental hemorrhage can be life threatening to a fetus and has important maternal treatment implications. In contrast, hereditary persistence of fetal hemoglobin is a condition that has little consequence. The Kleihauer-Betke test, which is routinely used to document transplacental hemorrhage, will be positive in either case.
CASES
We report two cases in which maternal persistence of fetal hemoglobin was unknown and led to the erroneous diagnosis of fetomaternal hemorrhage. These cases highlight both the limitations of the Kleihauer-Betke test and the role of flow cytometry in diagnosing fetomaternal hemorrhage.
CONCLUSION
The use of flow cytometry can clarify Kleihauer-Betke test results when there is known maternal persistence of fetal hemoglobin and can more precisely quantify a fetomaternal hemorrhage for accurate Rh immune globulin dosing.
背景
经胎盘出血可能危及胎儿生命，并对母体治疗具有重要意义。相比之下，胎儿血红蛋白遗传性持续存在是一种影响较小的情况。常用于记录经胎盘出血的克莱豪尔-贝特克试验在这两种情况下都会呈阳性。
病例
我们报告了两例病例，其中母体胎儿血红蛋白持续存在情况未知，导致了胎儿-母体出血的误诊。这些病例凸显了克莱豪尔-贝特克试验的局限性以及流式细胞术在诊断胎儿-母体出血中的作用。
结论
当已知母体存在胎儿血红蛋白持续存在时，使用流式细胞术可以澄清克莱豪尔-贝特克试验结果，并能更精确地量化胎儿-母体出血量，以便准确给予Rh免疫球蛋白。
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