Nicolaides K H, Rodeck C H, Mibashan R S, Kemp J R
Am J Obstet Gynecol. 1986 Jul;155(1):90-4. doi: 10.1016/0002-9378(86)90085-2.
Fetal blood and amniotic fluid samples were obtained fetoscopically from 59 rhesus-isoimmunized pregnancies at 18 to 25 weeks' gestation. Fetal hemoglobin was measured and amniotic fluid optical density deviation at a wavelength of 450 nm determined. Two sets of normal reference values for optical density at 450 nm and fetal hemoglobin at 16 to 36 and 16 to 25 weeks were established from 475 amniotic fluid and 153 fetal blood samples obtained from pregnancies not complicated by fetal hemolysis. As expected, there was a significant linear correlation between the degree of fetal anemia and the amniotic fluid optical density at 450 nm in rhesus-isoimmunized pregnancies. However, the values of optical density at 450 nm were widely scattered, thereby limiting their ability to predict accurately the severity of disease in these second-trimester pregnancies. In 25 of the patients, the value of optical density at 450 nm was determined at 6 to 16 days before fetoscopy. The severity of fetal anemia could not be predicted by the trend in optical density at 450 nm. These data suggest that the only reliable method to determine the severity of rhesus isoimmunization in the second trimester of pregnancy is the direct measurement of fetal hemoglobin.
在妊娠18至25周时，通过胎儿镜从59例恒河猴血型不合免疫的孕妇获取胎儿血液和羊水样本。测量胎儿血红蛋白，并测定羊水在450nm波长处的光密度偏差。从475份羊水样本和153份胎儿血液样本（取自无胎儿溶血并发症的妊娠）中，建立了两组关于450nm处光密度以及16至36周和16至25周胎儿血红蛋白的正常参考值。正如预期的那样，在恒河猴血型不合免疫的妊娠中，胎儿贫血程度与450nm处羊水光密度之间存在显著的线性相关性。然而，450nm处的光密度值分布广泛，从而限制了它们准确预测这些孕中期妊娠疾病严重程度的能力。在25例患者中，在胎儿镜检查前6至16天测定了450nm处的光密度值。胎儿贫血的严重程度无法通过450nm处光密度的变化趋势来预测。这些数据表明，在妊娠中期确定恒河猴血型不合免疫严重程度的唯一可靠方法是直接测量胎儿血红蛋白。
