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阿曼恒河猴阳性孕妇因红细胞抗体引起的同种免疫:母婴及围产期结局

Alloimmunization due to red cell antibodies in Rhesus positive Omani Pregnant Women: Maternal and Perinatal outcome.

作者信息

Al-Dughaishi Tamima, Al-Rubkhi Ikhlass S, Al-Duhli Maymoona, Al-Harrasi Yusra, Gowri Vaidyanathan

机构信息

Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.

5th Year Medical Student, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.

出版信息

Asian J Transfus Sci. 2015 Jul-Dec;9(2):150-4. doi: 10.4103/0973-6247.162710.

Abstract

OBJECTIVE

This study is aimed to determine the prevalence of alloimmunization due to antibodies to red blood cell (RBC) antigens (other than rhesus [Rh] antigen) and report the maternal, perinatal, and neonatal outcomes.

MATERIALS AND METHODS

A retrospective review of medical records of all patients with minor RBCs antibodies alloimmunization who were followed and delivered at Sultan Qaboos University Hospital, Oman from June 2011 to June 2013. Maternal characteristics, antibody type, antibody titer in addition to perinatal and neonatal outcomes were reviewed.

RESULTS

There were 1160 patients with Rh positive status in the study. The most common ABO blood group was O, followed by A, B, and AB. We found 33 out of 1160 Rh positive women alloimmunized with minor RBCs antibodies that gave a prevalence of minor RBCs alloimmunization of 2.7%. The most frequent antibody was anti-E 38%, followed by anti-c 17% and anti-kell 17%. 6 of these 33 patients were identified to have significant antibody titer, and two cases showed evidence of fetal anemia. Only one case required an intrauterine blood transfusion. The most common neonatal complication was jaundice in 53%, followed by respiratory distress syndrome in 28%. Two cases complicated by neonatal anemia required a postnatal blood transfusion.

CONCLUSION

Alloimmunization with anti-E, anti-c, and anti-kell were the most common antibodies among the study group. Minor RBCs alloimmunization was an important cause of neonatal morbidity.

摘要

目的

本研究旨在确定因抗红细胞(RBC)抗原(除恒河猴血型[Rh]抗原外)抗体导致的同种免疫的患病率,并报告孕产妇、围产期和新生儿结局。

材料与方法

对2011年6月至2013年6月在阿曼苏丹卡布斯大学医院接受随访并分娩的所有患有轻微RBC抗体同种免疫的患者的病历进行回顾性研究。回顾了孕产妇特征、抗体类型、抗体效价以及围产期和新生儿结局。

结果

本研究中有1160例Rh阳性患者。最常见的ABO血型是O型,其次是A型、B型和AB型。我们在1160例Rh阳性女性中发现33例因轻微RBC抗体发生同种免疫,轻微RBC同种免疫的患病率为2.7%。最常见的抗体是抗-E(38%),其次是抗-c(17%)和抗-Kell(17%)。这33例患者中有6例被确定具有显著的抗体效价,2例显示有胎儿贫血的证据。仅1例需要进行宫内输血。最常见的新生儿并发症是黄疸(53%),其次是呼吸窘迫综合征(28%)。2例并发新生儿贫血的病例需要进行产后输血。

结论

抗-E、抗-c和抗-Kell同种免疫是研究组中最常见的抗体。轻微RBC同种免疫是新生儿发病的重要原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27d6/4562135/0613564c2db3/AJTS-9-150-g002.jpg

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