Salfelder A, Kochanowicz J, Spenner R, Hickl E J
Frauenklinik Finkenau, Hamburg.
Z Geburtshilfe Neonatol. 1995 Mar-Apr;199(2):86-9.
Two cases of fetomaternal macrotransfusion in otherwise normal pregnancies are reported. In both cases the main symptoms observed by the patients were decreasing fetal movements. Cardiotocography revealed a highly pathologic pattern an immediate cesarean section was performed. The cause of massive fetomaternal hemorrhage (390 and 635 ml fetal blood) remains unclear. Delayed treatment leads to severe anemia followed by hypovolemic shock and ultimately to stillbirth. Pregnancies complicated by fetomaternal hemorrhage develop normally until signs of fetal decompensation begin to appear. Decreasing fetal movements in the most common symptom reported by the patients. In addition to a contraction-stress-test, blood from the pregnant women should be looked at for fetal erythrocytes, a test that can be performed very quickly and easily. If the fetus is viable, immediate delivery should be performed and blood transfusions to the newborn should be administered. In preterm pregnancies cordocentesis and intrauterine blood transfusion may be considered.
本文报告了两例正常妊娠合并母胎大量输血的病例。两例患者主要的症状均为胎动减少。胎心监护显示高度病理性图形,遂立即行剖宫产术。大量母胎出血(分别为390毫升和635毫升胎儿血液)的原因尚不清楚。治疗延迟会导致严重贫血,继而出现低血容量性休克,最终导致死产。合并母胎出血的妊娠通常正常发展,直至出现胎儿失代偿迹象。胎动减少是患者报告的最常见症状。除宫缩应激试验外,应检查孕妇血液中的胎儿红细胞,该检查可快速简便地进行。如果胎儿存活,应立即分娩并给新生儿输血。对于早产妊娠,可考虑进行脐带穿刺和宫内输血。