Studnicková M, L'ubuský M, Ordeltová M, Procházka M
Porodnicko-gynekologická klinika FN, Olomouc.
Ceska Gynekol. 2010 Oct;75(5):443-6.
Fetomaternal haemorrhage (FMH) is a status characterised by penetration of fetal blood into the maternal circulation which happens mostly at delivery. FMH may cause erythrocytal alloimmunisation of woman. That is why anti-D immunoglobulin (IgG anti-D) is being administered to RhD negative women after delivery of RhD positive fetus. IgG anti-D is administered to RhD negative women standardly and in much greater quantities than is actually necessary. However, on the other hand, it is not possible to diagnose cases where a greater dose is required. To optimalise prevention of RhD alloimmunization in RhD negative women, it is important to diagnose conditions where fetomaternal haemorrhage (FMH) occurs, precisely define its volume and consequently administer the required dose of IgG anti-D. The ability to reliably detect fetomaternal haemorrhage (FMH) and precisely define its volume would allow better and less expensive prevention of RhD alloimmunization in RhD negative women. IgG anti-D could thus be administered only in cases that are actually indicated and only in doses necessary for preventing RhD alloimmunization. Accurate quantification of FMH is determined by flow cytometry.
Review.
Department of Obstetrics and Gynecology, Department of Alergology and Clinical Immunology, University Hospital Olomouc.
胎儿-母体出血(FMH)是一种以胎儿血液进入母体循环为特征的状态,主要发生在分娩时。FMH可能导致女性红细胞同种免疫。这就是为什么在分娩出RhD阳性胎儿后,要给RhD阴性女性注射抗D免疫球蛋白(IgG抗D)。通常会给RhD阴性女性注射IgG抗D,且注射量远超过实际所需。然而,另一方面,无法诊断出需要更大剂量的情况。为了优化对RhD阴性女性RhD同种免疫的预防,重要的是诊断出发生胎儿-母体出血(FMH)的情况,精确确定其出血量,进而给予所需剂量的IgG抗D。可靠检测胎儿-母体出血(FMH)并精确确定其出血量的能力,将有助于更好且更经济地预防RhD阴性女性的RhD同种免疫。因此,仅在实际有指征的情况下,且仅给予预防RhD同种免疫所需剂量的IgG抗D。FMH的准确量化通过流式细胞术确定。
综述。
奥洛穆茨大学医院妇产科、过敏与临床免疫科。