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中国 RHD*DEL1 等位基因突变孕妇的输血管理。

Transfusion management of a Chinese pregnant woman with RHD*DEL1 allele.

机构信息

Department of Obstetrics & Gynecology, China-Japan Friendship Hospital, 100029 Beijing, China.

College of Medical Technology and Engineering, Henan University of Science and Technology, 471023 Luoyang, Henan, China.

出版信息

Transfus Clin Biol. 2021 Aug;28(3):293-295. doi: 10.1016/j.tracli.2021.05.001. Epub 2021 May 12.

Abstract

We report the case of a 33-year-old pregnant Chinese woman who typed as Rh-negative in routine serology. Two injections of RhIG were given and two Rh-negative red cell units were sourced and put aside then returned with a reduced shelf life. RHDDEL1 allele was determined in this woman by RHD genotyping two month later after delivery occasionally. In this representative case, a pregnant woman with RHDDEL1 allele can safely be managed as Rh-positive, avoiding the unnecessary procurement of Rh-negative red cells and payment for RhIG injections. We analyzed the cost benefit of using RHD genotyping to guide transfusion management on the Chinese pregnant woman in Beijing where the average salary level is top-ranked in China. Considering the healthcare condition in China, we recommend molecular analysis of serologic Rh-negative early in pregnancy before the Rh-negative transfusion and administration of RhIG become unnecessarily required.

摘要

我们报告了一例 33 岁的中国孕妇,其常规血清学检查结果为 Rh 阴性。给她注射了两针 RhIG,并准备了两个 Rh 阴性红细胞单位,但后来由于保质期缩短而退回。两个月后,在分娩后偶尔进行的 RHD 基因分型中确定了该妇女存在 RHDDEL1 等位基因。在这个有代表性的病例中,携带 RHDDEL1 等位基因的孕妇可以安全地被视为 Rh 阳性,从而避免不必要地采集 Rh 阴性红细胞和支付 RhIG 注射费用。我们分析了在中国北京(中国平均工资水平最高的城市之一)使用 RHD 基因分型指导输血管理的成本效益。考虑到中国的医疗保健状况,我们建议在 Rh 阴性输血和 RhIG 不必要地使用之前,对妊娠早期的血清学 Rh 阴性进行分子分析。

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