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新生儿溶血病:当前趋势与前景综述

Hemolytic Disease of the Newborn: A Review of Current Trends and Prospects.

作者信息

Myle Akshay Kiran, Al-Khattabi Ghanim Hamid

机构信息

Department of Clinical Research, General Medicine, Pharmacology, Integrative Medicine, Clinical Researcher. National Institute of Medicine Sciences, Poduru Mandalam City, Andhra Pradesh State, India.

Preventive Medicine and Public Health, Ministry of Health, Makkah City, Kingdom of Saudi-Arabia.

出版信息

Pediatric Health Med Ther. 2021 Oct 7;12:491-498. doi: 10.2147/PHMT.S327032. eCollection 2021.

Abstract

Hemolytic disease of the newborn (HDN), also known as , is a hemolytic condition that predominantly affects rhesus-positive fetuses and infants born to rhesus-negative mothers. The pathophysiology of HDN begins with maternal antibodies attacking fetal red blood cells following alloimmunization due to rhesus or ABO incompatibility between the maternal and fetal blood. Previously, HDN was known to cause fetal death in 1% of all pregnancies, but with the advent of immunoprophylactic therapies, the condition can be currently fairly well managed with fewer complications if diagnosed early. Diagnosis calls for extensive history taking, physical examination, serological studies, and imaging modalities such as pelvic ultrasound scans. To prevent the disease, earlier intravenous immunoglobulin (IVIG) should be given to pregnant Rh- women who have not been sensitized. It is also vital to understand prospective complications such as severe hyperbilirubinemia and develop appropriate remedies. Because of its great incidence and nature, HDN has been thoroughly explored, and more studies are being conducted each year, revealing new insights about the condition. This review covers the disorder's etiology, diagnosis, and management, including the most current findings as of 2021, as well as trends and prospects, to help in future research and evidence-based medical practice.

摘要

新生儿溶血病(HDN),也称为 ,是一种主要影响恒河猴阳性胎儿以及恒河猴阴性母亲所生婴儿的溶血性疾病。HDN的病理生理学始于母体抗体在因母体与胎儿血液之间的恒河猴或ABO血型不相容而发生同种免疫后攻击胎儿红细胞。以前,已知HDN在所有妊娠中导致1%的胎儿死亡,但随着免疫预防疗法的出现,如果早期诊断,目前该疾病可以得到较好的管理,并发症较少。诊断需要广泛采集病史、进行体格检查、血清学研究以及采用盆腔超声扫描等影像学检查方法。为预防该疾病,应尽早对未致敏的Rh- 孕妇给予静脉注射免疫球蛋白(IVIG)。了解诸如严重高胆红素血症等潜在并发症并制定适当的治疗方法也至关重要。由于其高发病率和特性,HDN已得到充分研究,并且每年都在进行更多研究,揭示有关该疾病的新见解。本综述涵盖该疾病的病因、诊断和管理,包括截至2021年的最新发现以及趋势和前景,以有助于未来的研究和循证医学实践。

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