Souabni Sara Ait, Habib Belhaddad El, Oubahha Ihsane, Baqali Jihane El, Aboulfalah Abderrahim, Soummani Abderraouf
Université Cadi Ayyad, Faculté de Médecine et de Pharmacie de Marrakech, Marrakech, Maroc.
Service de Gynécologie-Obstétrique, CHU Med VI Marrakech, Marrakech, Maroc.
Pan Afr Med J. 2021 Jan 20;38:67. doi: 10.11604/pamj.2021.38.67.26353. eCollection 2021.
Prior to 1970, maternal alloimmunization was the leading cause of perinatal death. Currently, it has become rarer thanks to screening and monitoring in high-risk pregnancies. The advent of transcranial doppler has been a turning point in the monitoring of these pregnancies, as it is a reliable, non-invasive method for the diagnosis of fetal anemia. This helps clinicians decide whether or not to perform intrauterine transfusion. Anti-D immunoprophylaxis has also played an important role in preventing fetal and neonatal hemolytic anemia and its administration is currently well codified. Adequate management helps to avoid the effects of alloimmunization on the fetus and newborn as well as to reduce the risks of alloimmunization in subsequent pregnancies. We here report a case of severe fetomaternal rhesus (Rh) alloimmunization during unmonitored pregnancy complicated by fetoplacental anasarca.
1970年以前，母体同种免疫是围产期死亡的主要原因。目前，由于对高危妊娠进行筛查和监测，这种情况已变得较为罕见。经颅多普勒的出现是这些妊娠监测中的一个转折点，因为它是诊断胎儿贫血的一种可靠、非侵入性方法。这有助于临床医生决定是否进行宫内输血。抗D免疫预防在预防胎儿和新生儿溶血性贫血方面也发挥了重要作用，目前其给药方法已有明确规范。充分的管理有助于避免同种免疫对胎儿和新生儿的影响，并降低后续妊娠中同种免疫的风险。我们在此报告一例未监测妊娠期间发生严重母胎恒河猴（Rh）同种免疫并伴有胎儿胎盘全身性水肿的病例。
