Chan Lin Wai, Lau Tze Kin, Chung Tony Kwok Hung
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR.
Curr Opin Obstet Gynecol. 2006 Apr;18(2):100-5. doi: 10.1097/01.gco.0000192981.69352.dc.
This review provides up-to-date information on the diagnosis and management of fetal anaemia.
Exciting advances in the field of red blood cell isoimmunization are phasing out the need for invasive procedures. Rhesus blood group genotyping using fetal DNA in maternal plasma has been introduced into clinical practice with remarkable success. The role of middle cerebral artery peak systolic velocity in screening for fetal anaemia has been confirmed in various causes of fetal anaemia. A recent review of a successful Iran national screening programme for thalassaemia provided a timely and valuable educational opportunity. The value of intrauterine transfusion as a treatment for fetal anaemia was demonstrated by both high success rate and low procedure-related pregnancy loss rate.
Fetal anaemia is one of the severe fetal conditions that affect the worldwide population. Rhesus isoimmunization remains an important health issue despite the recommendation for anti-D immunoglobulin prophylaxis and injection after sensitizing events. Noninvasive ultrasound diagnostic methods have replaced traditional invasive procedures in the assessment of fetus at risk of anaemia due to various causes, including red blood cell isoimmunization, parvovirus B19 infection and thalassaemia. The increased availability of intrauterine transfusion will help to improve the prognosis of these anaemic fetuses.
本综述提供胎儿贫血诊断与管理的最新信息。
红细胞同种免疫领域令人兴奋的进展正逐步减少侵入性操作的需求。利用母血中胎儿DNA进行恒河猴血型基因分型已成功引入临床实践。胎儿贫血各种病因中，大脑中动脉收缩期峰值流速在筛查胎儿贫血中的作用已得到证实。近期对伊朗一项成功的地中海贫血全国筛查项目的综述提供了及时且有价值的教育契机。宫内输血作为胎儿贫血治疗方法的价值通过高成功率和低操作相关妊娠丢失率得到了证明。
胎儿贫血是影响全球人口的严重胎儿疾病之一。尽管推荐在致敏事件后使用抗-D免疫球蛋白预防和注射，但恒河猴同种免疫仍然是一个重要的健康问题。非侵入性超声诊断方法已取代传统侵入性操作，用于评估因各种病因（包括红细胞同种免疫、细小病毒B19感染和地中海贫血）而有贫血风险的胎儿。宫内输血可及性的提高将有助于改善这些贫血胎儿的预后。
