Rose P G, Strohm P L, Zuspan F P
Am J Obstet Gynecol. 1985 Dec 15;153(8):844-7. doi: 10.1016/0002-9378(85)90687-8.
Fetomaternal hemorrhage can result from different types of trauma and may be followed by fetal anemia, fetal death, or isoimmunization. We prospectively studied the frequency and volume of fetomaternal hemorrhage, fetal well-being, abruptio placentae, and fetal outcome in 32 pregnant patients suffering recent trauma. Fetomaternal hemorrhage occurred in nine of 32 trauma patients (28%) with a mean volume of 16 ml +/- 14.3(SD). There was a statistically significant difference in the frequency and mean volume of fetomaternal hemorrhage in this group over that in gestational-age-matched controls. Neither the nature of the trauma nor the gestational age was related to the frequency or volume of fetomaternal hemorrhage. The outcome in three of the nine trauma patients who sustained fetomaternal hemorrhage was poor; fetal anemia, paroxysmal atrial tachycardia, and fetal death occurred in each one. Maternal trauma remains a significant cause of maternal and fetal morbidity and death, and the use of the Kleihauer-Betke analysis is indicated to identify fetomaternal hemorrhage. Rh-immune globulin therapy should be given to Rh-negative patients with fetomaternal hemorrhage.
母胎输血可由不同类型的创伤引起，随后可能会出现胎儿贫血、胎儿死亡或同种免疫。我们前瞻性地研究了32例近期遭受创伤的孕妇的母胎输血频率和输血量、胎儿健康状况、胎盘早剥及胎儿结局。32例创伤患者中有9例发生母胎输血（28%），平均输血量为16 ml±14.3（标准差）。该组母胎输血的频率和平均输血量与孕周匹配的对照组相比有统计学显著差异。创伤的性质和孕周均与母胎输血的频率或输血量无关。9例发生母胎输血的创伤患者中有3例结局不佳；分别出现了胎儿贫血、阵发性房性心动过速和胎儿死亡。母体创伤仍然是母婴发病和死亡的重要原因，应用克来豪尔-贝特克分析来识别母胎输血。对于发生母胎输血的Rh阴性患者应给予Rh免疫球蛋白治疗。
