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因血型不合免疫所致胎儿贫血的诊断与治疗。

Diagnosis and treatment of fetal anemia due to isoimmunization.

作者信息

Plöckinger B, Strümpflen I, Deutinger J, Bernaschek G

机构信息

Department of Prenatal Diagnosis and Therapy, University of Vienna, Austria.

出版信息

Arch Gynecol Obstet. 1994;255(4):195-200. doi: 10.1007/BF02335085.

DOI:10.1007/BF02335085
PMID:7695366
Abstract

45 pregnant women affected by rhesus incompatibility were treated at the Department of Prenatal Diagnosis and Therapy, Vienna, between January 1992 and March 1993. 32 patients had a cordocentesis and on 21 fetuses, anemia requiring treatment was diagnosed. A total of 71 intravascular transfusions via the umbilical vein was given. The mean number of transfusions per fetus was 3.4 (range 1-11). Of the 7 fetuses who had already developed hydrops when therapy was started (hematocrit < 13%), 5 (71%) survived. The survival rate of non-hydropic anemic fetuses was 93% (13/14). By using intravascular transfusion for treatment of severe fetal anemia, a success rate of 86% (18/21) was achieved.

摘要

1992年1月至1993年3月期间,维也纳产前诊断与治疗科对45名受恒河猴血型不相容影响的孕妇进行了治疗。32名患者接受了脐带穿刺术,其中21例胎儿被诊断出需要治疗的贫血。共通过脐静脉进行了71次血管内输血。每个胎儿输血的平均次数为3.4次(范围为1 - 11次)。在治疗开始时已经出现水肿的7例胎儿(血细胞比容<13%)中,5例(71%)存活。非水肿性贫血胎儿的存活率为93%(13/14)。通过使用血管内输血治疗严重胎儿贫血,成功率达到了86%(18/21)。

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1
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本文引用的文献

1
The management of severe rhesus isoimmunization by fetoscopic intravascular transfusions.通过胎儿镜血管内输血治疗严重恒河猴血型不合免疫。
Am J Obstet Gynecol. 1984 Nov 15;150(6):769-74. doi: 10.1016/0002-9378(84)90683-5.
2
In utero exchange transfusion by direct intravascular injection in severe erythroblastosis fetalis.在重症胎儿成红细胞增多症中通过直接血管内注射进行宫内换血。
N Engl J Med. 1986 May 29;314(22):1431-4. doi: 10.1056/NEJM198605293142207.
3
The reversal of hydrops fetalis by intravascular intrauterine transfusion in severe isoimmune fetal anemia.
Am J Obstet Gynecol. 1988 Apr;158(4):914-9. doi: 10.1016/0002-9378(88)90094-4.
4
Intravascular monitoring and management of erythroblastosis fetalis.胎儿成红细胞增多症的血管内监测与管理
Am J Obstet Gynecol. 1988 Apr;158(4):783-95. doi: 10.1016/0002-9378(88)90073-7.
5
Rh disease: intravascular fetal blood transfusion by cordocentesis.新生儿溶血病:经脐静脉穿刺进行胎儿血管内输血。
Fetal Ther. 1986;1(4):185-92. doi: 10.1159/000262267.
6
Intrauterine intravascular transfusions for severe red blood cell isoimmunization: ultrasound-guided percutaneous approach.严重红细胞同种免疫的宫内血管内输血:超声引导下经皮穿刺法
Am J Obstet Gynecol. 1986 Sep;155(3):574-81. doi: 10.1016/0002-9378(86)90282-6.
7
Two hundred intrauterine exchange transfusions in severe blood incompatibilities.针对严重血型不合进行的两百次宫内换血输血
Am J Obstet Gynecol. 1989 Sep;161(3):709-13. doi: 10.1016/0002-9378(89)90386-4.
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Consequences of fetomaternal haemorrhage after intrauterine transfusion.宫内输血后母胎输血的后果。
BMJ. 1988 Nov 26;297(6660):1379-81. doi: 10.1136/bmj.297.6660.1379.
9
Intrauterine transfusion--intraperitoneal versus intravascular approach: a case-control comparison.宫内输血——腹腔内与血管内途径:病例对照比较
Am J Obstet Gynecol. 1990 Apr;162(4):1053-9. doi: 10.1016/0002-9378(90)91314-3.
10
Enhanced sensitization after cordocentesis in a rhesus-isoimmunized pregnancy.恒河猴血型同种免疫妊娠行脐静脉穿刺术后致敏增强。
Am J Obstet Gynecol. 1991 Aug;165(2):382-3. doi: 10.1016/0002-9378(91)90098-c.