Clarke C A, Mollison P L, Whitfield A G
Br Med J (Clin Res Ed). 1985 Jul 6;291(6487):17-9. doi: 10.1136/bmj.291.6487.17.
Examination of death certificates and the clinical notes of the patients concerned showed that the number of deaths from rhesus (D) haemolytic disease in England and Wales was 44 and 34 during 1982 and 1983, respectively, a substantial decrease from the figure of 106 for 1977. Of the 78 women whose infants died in 1982 and 1983, 49 had not received anti-Rh immunoglobulin after previous pregnancies with Rh positive infants; most of these deaths would presumably have been prevented had postnatal anti-Rh immunoglobulin been given. In 13 women anti-D was detected during, or immediately after, a first pregnancy, and in 15 women rhesus immunisation developed despite administration of anti-Rh immunoglobulin postnatally. One or two apparent failures of treatment may have been due to underdosage, but it must be concluded that about one third of the deaths in 1982 and 1983 could have been prevented only by giving anti-Rh immunoglobulin antenatally as well as postnatally.
对死亡证明及相关患者临床记录的审查显示,1982年和1983年期间,英格兰和威尔士因恒河猴(D)溶血病死亡的人数分别为44人和34人,与1977年的106人相比大幅下降。在1982年和1983年其婴儿死亡的78名女性中,有49名在之前怀有Rh阳性婴儿的妊娠后未接受抗Rh免疫球蛋白治疗;如果产后给予抗Rh免疫球蛋白,这些死亡中的大多数可能会被避免。在13名女性的首次妊娠期间或刚结束后检测到了抗D,还有15名女性尽管产后给予了抗Rh免疫球蛋白仍发生了Rh免疫。一两次明显的治疗失败可能是由于剂量不足,但必须得出结论,1982年和1983年约三分之一的死亡只有通过产前和产后都给予抗Rh免疫球蛋白才能避免。