Hensleigh P A
Am J Obstet Gynecol. 1983 Aug 1;146(7):749-55.
The controversial proposal to use Rho (D) immune globulin (human) prophylactically in pregnancy should not detract from the most expedient approach to further reduction of Rh disease; that is, to ensure that every eligible woman is given Rho (D) immune globulin (human) after delivery, abortion, or ectopic pregnancy. Family planning by Rh-negative women at risk and limiting the number of pregnancies in women already immunized will be additional effective ways to reduce the current incidence of hemolytic disease in most communities. Present evidence shows that blanket antepartum Rho (D) immune globulin (human) prophylactic treatment will be very costly and will place many subjects at potential risk while offering benefit to only a few. Sensitive and practical laboratory testing for fetomaternal hemorrhage is presently only a research tool but will soon be clinically available to provide new data on fetomaternal hemorrhage. In the near future, pregnant women truly at risk for Rh isoimmunization may be identified by analysis of their blood, and this will be a rational basis for antepartum Rho (D) immune globulin (human) treatment. There are compelling advantages in cost, risks, and benefits for an approach of selective antepartum Rho (D) immune globulin (human) therapy as opposed to routine prophylaxis for all Rh-negative gravid women.
关于在孕期预防性使用人源Rho（D）免疫球蛋白这一有争议的提议，不应偏离进一步降低Rh溶血病最便捷的方法；也就是说，要确保每一位符合条件的女性在分娩、流产或异位妊娠后都能获得人源Rho（D）免疫球蛋白。Rh阴性高危女性进行计划生育以及限制已免疫女性的妊娠次数，将是大多数社区降低当前溶血病发病率的额外有效方法。现有证据表明，大规模产前预防性使用人源Rho（D）免疫球蛋白成本高昂，会使许多对象面临潜在风险，而仅对少数人有益。目前，用于检测母胎输血的灵敏实用的实验室检测方法仅为一种研究工具，但很快将可用于临床，以提供有关母胎输血的新数据。在不久的将来，通过分析血液可识别真正有Rh同种免疫风险的孕妇，这将成为产前使用人源Rho（D）免疫球蛋白治疗的合理依据。与对所有Rh阴性孕妇进行常规预防相比，选择性产前使用人源Rho（D）免疫球蛋白治疗在成本、风险和益处方面具有显著优势。
