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孕早期羊膜腔穿刺术后母胎输血——1000例病例评估(作者译)

[Foetomaternal transfusions after amniocentesis in early pregnancy - evaluation of 1,000 cases (author's transl)].

作者信息

Schmidt W, Gabelmann J, Boos R, Garoff L, Kubli K

出版信息

Z Geburtshilfe Perinatol. 1980 Oct;184(5):359-65.

PMID:6169212
Abstract

The foetal haemoglobin (HbF) content was determined before and 2 hours after amniocentesis in 1,000 cases of amniocentesis conditioned by genetic indication (between the 15th and 20th pregnancy week). HbF-identification was effected according to the method of Kleinhauer and Betke. In primarily (before amniocentesis) negative HbF findings, HbF positive findings after amniocentesis were obtained in 7.2% of the patients. However, if the HbF-determinations were positive already before amniocentesis, a quantitative increase of HbF-cells in the maternal blood smear after amniocentesis was observed in 15.9% of the patients. Patients with punctures in the case of placenta of the anterior wall showed and increase in HbF values after amniocentesis in 12.2% of the cases, compared against 8.9% only in patients with posterior wall placenta, but these differences were statistically not significant. Amniocentesis under ultrasonic visual control caused a drop in the number of repeated amniocentesis trials to 20/500, aspiration of bloodstained amniotic fluid to 3.6% and HbF-cell positive blood smears after amniocentesis to 7%. (Free-hand-needle-technique: amniocentesis failures 42/500, amniotic fluid samples contaminated with blood in 9.6% of the cases and increases in HbF-values after amniocentesis in 12.6% of the cases). A total of 82 Rh-negative patients were given conventional anti-D-prophylaxis independent of the localisation of placenta. No sensitization was observed in any of the cases. No boosting was caused by early amniocentesis in cases where a positive anti-body finding had been established (3 cases to date).

摘要

在1000例因遗传指征而行羊膜腔穿刺术(妊娠第15至20周)的病例中,于羊膜腔穿刺术前及术后2小时测定胎儿血红蛋白(HbF)含量。HbF鉴定采用Kleinhauer和Betke方法。在最初(羊膜腔穿刺术前)HbF检测结果为阴性的患者中,7.2%的患者在羊膜腔穿刺术后出现HbF阳性结果。然而,如果在羊膜腔穿刺术前HbF检测就已呈阳性,15.9%的患者在羊膜腔穿刺术后母体血涂片上HbF细胞数量出现定量增加。前壁胎盘穿刺的患者中,12.2%的病例在羊膜腔穿刺术后HbF值升高,而后壁胎盘患者中这一比例仅为8.9%,但这些差异无统计学意义。超声直视引导下的羊膜腔穿刺术使重复羊膜腔穿刺术的次数降至20/500,血性羊水抽吸率降至3.6%,羊膜腔穿刺术后HbF细胞阳性血涂片率降至7%。(徒手穿刺技术:羊膜腔穿刺失败42/500,9.6%的病例羊水样本被血液污染,12.6%的病例羊膜腔穿刺术后HbF值升高)。总共82例Rh阴性患者接受了常规抗D预防,与胎盘位置无关。所有病例均未观察到致敏现象。在已确定抗体阳性的病例中(迄今为止3例),早期羊膜腔穿刺术未引起抗体增强。

相似文献

1
[Foetomaternal transfusions after amniocentesis in early pregnancy - evaluation of 1,000 cases (author's transl)].孕早期羊膜腔穿刺术后母胎输血——1000例病例评估(作者译)
Z Geburtshilfe Perinatol. 1980 Oct;184(5):359-65.
2
[On the feto-maternal transfusion of red blood cells during transplacental and para-placental genetic amniocenteses (author's transl)].关于经胎盘和胎盘旁遗传羊膜穿刺术期间胎儿-母体红细胞输血(作者译)
Geburtshilfe Frauenheilkd. 1979 May;39(5):378-83.
3
[Feto-maternal microtranfusion after amniocentesis in the 2nd trimenon (author's transl)].孕中期羊膜腔穿刺术后的母胎微量输血(作者译)
Med Klin. 1976 Jan 9;71(2):60-2.
4
[Fetomaternal transfusions in early pregnancy].[孕早期母胎输血]
Z Geburtshilfe Perinatol. 1991 Mar-Apr;195(2):71-5.
5
Rh sensitization after genetic amniocentesis.遗传羊膜腔穿刺术后的Rh致敏
Obstet Gynecol. 1980 Oct;56(4):459-61.
6
Fetal-maternal bleeding associated with genetic amniocentesis.与基因羊膜穿刺术相关的胎儿-母体出血
Obstet Gynecol. 1980 Jan;55(1):48-54.
7
Risks of fetomaternal hemorrhage resulting from amniocentesis with and without ultrasound placental localization.有无超声胎盘定位的羊膜腔穿刺术导致母胎输血的风险。
Obstet Gynecol. 1975 Oct;46(4):389-91.
8
[Alpha fetoprotein and HbF cells in the maternal blood and their modification through amniocentesis].[母血中的甲胎蛋白和血红蛋白F细胞及其通过羊膜穿刺术的改变]
Fortschr Med. 1979 Jun 7;97(21):981-6.
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Diagnostic mid trimester amniocentesis: how safe?孕中期诊断性羊膜穿刺术:有多安全?
Am J Obstet Gynecol. 2004 Aug;191(2):607-15. doi: 10.1016/j.ajog.2004.05.078.
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[Gel agglutination test--a new test system for semiquantitative detection of feto-maternal transfusion in Rhesus incompatibility].[凝胶凝集试验——恒河猴血型不合中母胎输血半定量检测的新测试系统]
Z Geburtshilfe Neonatol. 1999 Nov-Dec;203(6):241-5.