Trolle B
Kolding Hospital, Denmark.
Acta Obstet Gynecol Scand. 1989;68(1):45-7. doi: 10.3109/00016348909087688.
As immune globulin anti-D given in the immediate post partum period fails to prevent the development of anti-D antibodies in about 1.5-2% of women at risk, probably as a result of feto-maternal bleeding during pregnancy, 300 micrograms of immune globulin anti-D was administered to 609 Rh-negative women in the 28th gestational week. Three hundred and forty-six had Rh-positive babies, and were given additionally 200 micrograms anti-D post partum. Of these, 291 had an antibody screen test done 10 months after delivery. No anti-D antibodies were found. The test results of the study group were compared with those of a control group of 354 women who did not receive prenatal immune globulin, but otherwise the same examinations and treatment. In this group, 322 had a screen test performed 10 months post partum or in their next pregnancy, when 1.8% had anti-D antibodies. The difference in immunization incidence between the groups was significant (p less than 0.05). There was no difference between the groups regarding the number of women with fetal erythrocytes in serum after delivery, but the number of fetal erythrocytes found was significantly lower in the group receiving prenatal prophylaxis (p less than 0.001). No adverse effects were found in the infants exposed to anti-D prenatally.
由于产后立即给予的抗-D免疫球蛋白在约1.5%-2%有风险的女性中未能预防抗-D抗体的产生,这可能是由于孕期母婴出血所致,因此在孕28周时对609名Rh阴性女性给予了300微克抗-D免疫球蛋白。其中346名产下Rh阳性婴儿的女性在产后还额外给予了200微克抗-D。这些女性中,291名在分娩10个月后进行了抗体筛查试验,未发现抗-D抗体。将研究组的检测结果与354名未接受产前免疫球蛋白但接受相同检查和治疗的女性对照组的结果进行了比较。在该对照组中,322名女性在产后10个月或下次怀孕时进行了筛查试验,其中1.8%有抗-D抗体。两组之间的免疫发生率差异具有统计学意义(p<0.05)。两组在产后血清中含有胎儿红细胞的女性数量上没有差异,但接受产前预防的组中发现的胎儿红细胞数量显著更低(p<0.001)。在产前接触抗-D的婴儿中未发现不良反应。