Studnickova M, Lubusky M, Simetka O, Petros M, Ordeltova M, Prochazka M, Vomáčková K, Langová K
Porodnicko-gynekologicka klinika, Olomouc.
Ceska Gynekol. 2012 Jun;77(3):256-61.
Determine the influence of maternal age, parity, gestational age and birth weight on the volume of fetal erythrocytes which enter the maternal circulation during spontaneous delivery. Determining these parameters would enable improving the guidelines for RhD alloimmunization prophylaxis.
Prospective clinical study.
Department of Obstetrics and Gynecology, University Hospital, Olomouc.
A total of 2413 examinations were performed. The amount of fetal erythrocytes entering maternal circulation during uncomplicated spontaneous delivery of one fetus was determined by flow cytometry using the BDFACSCanto cytometer (Becton Dickonson International). Laboratory processing: Fetal Cell Count kit (Diagnosis of Feto-maternal transfusion by flow cytometry), IQ Products, IQP-379. Calculation of total volume of fetal erythrocytes entering maternal circulation: Scientific Subcommittee of the Australian and New Zealand Society of Blood Transfusion. Guidelines for laboratory assessment of fetomaternal haemorrhage. 1st ed. Sydney: ANZSBT, 2002: 3-12.
The average maternal age when FMH 1.8 ml (95 perc) was 29.4 years vs. 29.1 years when FMH > 1.8 ml, median 30 years in both groups, the difference was not statistically significant (p = 0.501). The average gestational age when FMH 1.8 ml (95 perc) was 275.3 days vs. 276.9 days when FMH > 1.8 ml, median 278 days (39 weeks +5 days) vs. 276 days (39 weeks + 3 days), the difference was not statistically significant (p = 0.849). The average birth weight when FMH 1.8 ml (95 perc) was 3312 g vs. 3353 g when FMH > 1.8 ml, median 3340 g vs. 3330 g, the difference was not statistically significant (p = 0.743). FMH > 1.8 ml (5 perc) was present in 4.1% of primiparas (42/1023), in 4.2% of secundiparas (44/1050) and in 5.3% of multiparas (18/340), the difference was not statistically significant (p = 0.607). The difference in maternal age, parity, gestational age and birth weight were also not statistically significant for fetomaternal hemorrhage FMH > 2.1 ml (2.5 perc), FMH > 2.5 ml (n = 25), FMH > 5 ml (n = 5).
Maternal age, parity, gestational age and birth weight does not present a risk factor for excessive fetomaternal hemorrhage during spontaneous delivery.
确定产妇年龄、产次、孕周和出生体重对自然分娩期间进入母体循环的胎儿红细胞量的影响。确定这些参数将有助于改进RhD同种免疫预防指南。
前瞻性临床研究。
奥洛穆茨大学医院妇产科。
共进行了2413次检查。使用BD FACSCanto流式细胞仪（Becton Dickonson International）通过流式细胞术确定单胎自然分娩过程中进入母体循环的胎儿红细胞量。实验室处理：胎儿细胞计数试剂盒（通过流式细胞术诊断胎儿 - 母体输血），IQ Products，IQP - 379。计算进入母体循环的胎儿红细胞总体积：澳大利亚和新西兰输血协会科学小组委员会。胎儿 - 母体出血实验室评估指南。第1版。悉尼：ANZSBT，2002：3 - 12。
胎儿 - 母体出血（FMH）≤1.8 ml（第95百分位数）时产妇平均年龄为29.4岁；FMH＞1.8 ml时为29.1岁；两组中位数均为30岁，差异无统计学意义（p = 0.501）。FMH≤1.8 ml（第95百分位数）时平均孕周为275.3天；FMH＞1.8 ml时为276.9天；中位数分别为278天（39周 +5天）和276天（39周 + 3天），差异无统计学意义（p = 0.849）。FMH≤1.8 ml（第95百分位数）时平均出生体重为3312 g；FMH＞1.8 ml时为3353 g；中位数分别为3340 g和3330 g，差异无统计学意义（p = 0.743）。初产妇中FMH＞1.8 ml（第5百分位数）的占4.1%（42/1023），经产妇中占4.2%（44/1050）；多产妇中占5.3%（18/340），差异无统计学意义（p = 0.607）。对于胎儿 - 母体出血FMH＞2.1 ml（第2.5百分位数）、FMH＞2.5 ml（n = 25）、FMH＞5 ml（n = 5），产妇年龄、产次、孕周和出生体重的差异也无统计学意义。
产妇年龄、产次、孕周和出生体重不是自然分娩期间胎儿 - 母体大量出血的危险因素。
