Department of Obstetrics and Gynecology, Pennsylvania State University College of Medicine, Hershey Medical Center, Pennsylvania.
Population Research Center, University of Texas at Austin, Austin, TX, United States.
Contraception. 2022 Oct;114:1-5. doi: 10.1016/j.contraception.2022.07.002. Epub 2022 Jul 21.
Historical evidence that fetal red blood cell (RBC) exposure during early spontaneous or induced abortion can cause maternal Rh sensitization is limited. A close reading of these studies indicates that forgoing Rh immunoglobulin administration before 12weeks gestation is highly unlikely to increase risk of Rh (D) antibody development, and recent studies indicate that fetal RBC exposure during aspiration abortion <12 weeks gestation is below the calculated threshold to cause maternal Rh sensitization, and the amount of fetomaternal hemorrhage during dilation and evacuation procedures up to 18weeks gestation is adequately treated with 100mcg of Rh immunoglobulin. We provide updated recommendations for Rh immunoglobulin administration based on this new evidence.
早期自发性或诱导性流产期间胎儿红细胞（RBC）暴露可导致母体 Rh 致敏的历史证据有限。仔细阅读这些研究表明，在 12 周妊娠前放弃 Rh 免疫球蛋白的给药极不可能增加 Rh（D）抗体产生的风险，并且最近的研究表明，在抽吸流产<12 周妊娠期间胎儿 RBC 暴露低于引起母体 Rh 致敏的计算阈值，在扩张和排空手术期间的胎儿-母体出血<18 周妊娠时，用 100μg 的 Rh 免疫球蛋白充分治疗。根据这一新证据，我们提供了 Rh 免疫球蛋白给药的更新建议。
