Bowman J M
Semin Hematol. 1975 Apr;12(2):189-207.
Great advances have been made in the management of Rh erythroblastosis fetalis in the past two decades. Perinatal mortality has been reduced from 16.4% to 3.2%. However, perinatal mortality can only be reduced to zero if Rh erythroblastosis can be eradicated by prevention of Rh isoimmunization. Although prevention of Rh immunization by Rh immune globulin prophylaxis is now a reality, it does not appear that Rh immunization will be completely prevented with a single postdelivery injection. Antenatal treatment plus screening by the Kleihauer technique for massive transplacental hemorrhage may be necessary before complete suppression can be achieved. Low protein Rh immune globulin, and ultimately column-produced, very low protein, highly purified Rh immune globulin for intravenous use may prove to be the safest, most economical, and effective material for Rh prevention and total eradication of Rh erythroblastosis fetalis.
在过去二十年中,胎儿溶血病(Rh erythroblastosis fetalis)的治疗取得了巨大进展。围产期死亡率已从16.4%降至3.2%。然而,只有通过预防Rh血型免疫才能根除胎儿溶血病,围产期死亡率才能降至零。虽然现在通过Rh免疫球蛋白预防来预防Rh免疫已成为现实,但似乎单次产后注射并不能完全预防Rh免疫。在实现完全抑制之前,可能需要进行产前治疗,并通过克莱豪尔技术(Kleihauer technique)筛查大量经胎盘出血。低蛋白Rh免疫球蛋白,最终可能是柱生产的、极低蛋白、高度纯化的静脉注射用Rh免疫球蛋白,可能被证明是预防Rh和彻底根除胎儿溶血病最安全、最经济有效的物质。