Division of Pediatric Hematology and Oncology, Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan.
Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.
Taiwan J Obstet Gynecol. 2022 Jul;61(4):722-725. doi: 10.1016/j.tjog.2022.04.006.
The prenatal course of a rare case with fetal anemia caused by maternal anti-c alloimmunization was reported.
A 39-year-old female with anti-c and anti-E antibodies against red cells had previously experienced a stillbirth. At her present pregnancy, titers of maternal antibodies and fetal middle cerebral artery peak systolic velocity (MCA-PSV) were frequently monitored to investigate the severity of fetal hemolytic anemia. Rather than manifesting as an increase in MCA-PSV, the anemic fetus was delivered at 32 weeks and one day of gestation with a sole presentation: polyhydramnios. Neonatal hospitalization course were compatible with hemolytic anemia. The baby was discharged at 48 days of age.
This case illustrated the complexities of dealing with maternal red cell alloimmunization during pregnancy and the limitations of noninvasive diagnostic modalities for detecting fetal anemia, and highlighted that obstetricians should refer all available clinical parameters in order to offer appropriate perinatal care.
报道 1 例罕见的由母体抗-c 同种免疫引起胎儿贫血的产前病程。
1 名 39 岁女性，红细胞存在抗-c 和抗-E 抗体，曾经历过死胎。在本次妊娠中，频繁监测母体抗体滴度和胎儿大脑中动脉收缩期峰值流速（MCA-PSV），以评估胎儿溶血性贫血的严重程度。贫血胎儿并未表现出 MCA-PSV 升高，而是在妊娠 32 周零 1 天分娩，唯一表现为羊水过多。新生儿住院过程符合溶血性贫血。婴儿在 48 天龄时出院。
该病例说明了在妊娠期间处理母体红细胞同种免疫的复杂性，以及非侵入性诊断方法在检测胎儿贫血方面的局限性，并强调了产科医生应参考所有可用的临床参数，以提供适当的围产期护理。
