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通过系列宫内输血对因抗-M同种免疫所致严重胎儿溶血病进行产前治疗。

Prenatal treatment of severe fetal hemolytic disease due to anti-M alloimmunization by serial intrauterine transfusions.

作者信息

Li Lin, Huang Linhuan, Luo Guangping, Luo Yanmin, Fang Qun

机构信息

Fetal Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-Sen University, China.

Institute of Clinical Blood Transfusion, Guangzhou Blood Center, Guangzhou, China.

出版信息

Taiwan J Obstet Gynecol. 2017 Jun;56(3):379-381. doi: 10.1016/j.tjog.2017.04.022.

Abstract

OBJECTIVE

Fetal hemolytic disease is a common cause of fetal hydrops and fetal morbidity and mortality. Despite its relatively low frequency, the anti-M IgG antibody is one of the causes of severe fetal anemia and intrauterine death; only a few cases have been reported.

CASE REPORT

This is a case of a pregnant woman with a history of three intrauterine deaths. A diagnosis of severe fetal anemia attributed to anti-M alloimmunization was confirmed in her fifth pregnancy. She came to our center for regular monitoring at the beginning of the pregnancy. Five intrauterine transfusions were performed to correct moderate to severe fetal anemia throughout her pregnancy. A male infant, delivered at the 36th gestational week received two transfusions after birth, and no neurologic abnormalities were observed until the child was 6 months of age.

CONCLUSION

Anti-M alloimmunization is an important cause of severe fetal hemolytic disease. The characteristics of fetal hemolytic disease due to anti-M alloimmunization may be somewhat different from those of disease due to anti-D alloimmunization.

摘要

目的

胎儿溶血病是胎儿水肿以及胎儿发病和死亡的常见原因。尽管抗-M IgG抗体相对少见,但它是导致严重胎儿贫血和宫内死亡的原因之一;仅有少数病例报道。

病例报告

这是一名有三次宫内死胎病史的孕妇。在其第五次妊娠时确诊为因抗-M同种免疫所致的严重胎儿贫血。妊娠初期她前来我们中心进行常规监测。在整个孕期进行了5次宫内输血以纠正中度至重度胎儿贫血。一名男婴在孕36周时出生,出生后接受了两次输血,直至该儿童6个月大时未观察到神经学异常。

结论

抗-M同种免疫是严重胎儿溶血病的重要原因。抗-M同种免疫所致胎儿溶血病的特征可能与抗-D同种免疫所致疾病的特征有所不同。

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