Harman C R, Bowman J M, Manning F A, Menticoglou S M
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, Canada.
Am J Obstet Gynecol. 1990 Apr;162(4):1053-9. doi: 10.1016/0002-9378(90)91314-3.
Intravascular fetal transfusion has gained widespread acceptance and has supplanted the use of intraperitoneal fetal transfusion in management of severe alloimmune disease in many centers. This study compares the two methods with regard to multiple objective end points of performance, therapy, and outcome in a highly matched case-control fashion. The intravascular approach is better on almost every level. More surviving infants who are in better condition at a mature gestation and whose mothers have fewer complications and sequelae are the result. Whereas intraperitoneal transfusion should not be abandoned altogether, it is a second-line procedure used only in very limited circumstances. Intravascular fetal transfusion offers realistic prognosis for intact survival at virtually any extreme of alloimmune disease.
血管内胎儿输血已得到广泛认可，并在许多中心取代了腹腔内胎儿输血在严重同种免疫性疾病治疗中的应用。本研究以高度匹配的病例对照方式，就性能、治疗和结局的多个客观终点对这两种方法进行了比较。血管内方法在几乎每个层面都更优。结果是更多存活婴儿在成熟孕周时状况更好，其母亲的并发症和后遗症更少。虽然腹腔内输血不应完全被摒弃，但它是仅在非常有限的情况下使用的二线操作。血管内胎儿输血为几乎任何严重程度的同种免疫性疾病实现完整存活提供了现实的预后。
