Sebring E S, Polesky H F
Memorial Blood Center of Minneapolis, Minnesota.
Transfusion. 1990 May;30(4):344-57. doi: 10.1046/j.1537-2995.1990.30490273444.x.
Most women have only very small amounts of fetal blood in their circulations following pregnancy and delivery: the volume is less than 0.5 mL of whole blood in 93 percent of women, less than 1 mL in 96 percent, and less than 2 mL in 98 percent. FMH of 30 mL or more occurs in just 3 of 1000 women. When the FMH was 150 mL or more, 15 of 41 infants did not survive Rh-negative women with FMH of more than 30 mL of Rh-positive whole blood are at increased risk of Rh immunization, and thus the outcome of their future pregnancies also may be affected. ABO-compatible fetal red cells that have entered the maternal circulation have a life span similar to that of adult cells. ABO-incompatible fetal red cells may be cleared rapidly, but in some cases they circulate for weeks. Most FMHs of 30 mL or more occur before labor, delivery, or cesarean section. The majority occur with minimal clinical signs and symptoms in apparently normal pregnancies. The identification of postpartum Rh-negative women who have 30 mL or more of Rh-positive fetal blood in their circulation is important so that sufficient RhIG for immune suppression can be administered. It appears that more than one-half of women with FMH of 30 mL or more would not be identified if protocols were adopted to test only women in pregnancies considered to be at high risk.
大多数女性在怀孕和分娩后，其循环系统中仅含有极少量的胎儿血液：93%的女性全血中胎儿血液量少于0.5毫升，96%少于1毫升，98%少于2毫升。每1000名女性中仅有3人会出现30毫升及以上的胎儿-母体出血（FMH）。当FMH达到150毫升及以上时，41名婴儿中有15名未能存活。FMH超过30毫升Rh阳性全血的Rh阴性女性发生Rh免疫的风险增加，因此她们未来妊娠的结局也可能受到影响。进入母体循环的ABO血型相容的胎儿红细胞寿命与成人细胞相似。ABO血型不相容的胎儿红细胞可能会迅速清除，但在某些情况下会循环数周。大多数30毫升及以上的FMH发生在分娩、剖宫产之前。大多数发生在看似正常的妊娠中，临床症状和体征极少。识别产后循环系统中含有30毫升及以上Rh阳性胎儿血液的Rh阴性女性很重要，以便能够给予足够的Rh免疫球蛋白进行免疫抑制。如果仅对被认为处于高风险妊娠的女性进行检测，似乎超过一半FMH达到30毫升及以上的女性将无法被识别。
