Gupte S C, Kulkarni S S
Institute of Immunohaematology (ICMR), Maharashtra, India.
Natl Med J India. 1994 Mar-Apr;7(2):65-6.
The Institute of Immunohaematology has had an Rh clinic at the Nowrosjee Wadia Maternity Hospital since 1957. Between then and 1977, 5% Rh-negative women produced Rh antibodies. Between 1978 and 1980, the rate of immunization was reduced to 3.3%. In the present study we determined the incidence of Rh immunization between 1981 and 1992.
ABO and Rh grouping was carried out by standard methods on 139,635 samples collected from antenatal women. Six thousand nine hundred and fourteen (5%) Rh-negative women were screened for Rh antibodies using an enzyme technique. Analysis was carried out by dividing the data into four groups, each of three years duration.
The number of women attending the antenatal outpatients increased steadily but the frequency of Rh-negativity remained at approximately 5%. The rate of Rh immunization among Rh-negative women declined from 3.1% during 1981-83 to 1.7% during 1990-92. The rate among pregnant women dropped from 0.16% to 0.09% and this was statistically significant (p < 0.05). The incidence of Rh immunization among Rh-negative women increased from 0.4% in the first pregnancy to 17.5% after four or more pregnancies (p < 0.01). Only 15 out of 167 Rh immunized women had received anti-D immunoglobulin previously.
The incidence of Rh immunization has declined during the last 12 years possibly due to family planning and extensive use of anti-D immunoglobulin. However, complete eradication of Rh haemolytic disease of the newborn will be possible only if a comprehensive Rh prophylaxis programme is instituted.
自1957年起，免疫血液学研究所在瑙罗斯吉·瓦迪亚妇产医院开设了Rh诊所。在1957年至1977年期间，5%的Rh阴性女性产生了Rh抗体。1978年至1980年期间，免疫率降至3.3%。在本研究中，我们确定了1981年至1992年期间Rh免疫的发生率。
采用标准方法对从产前妇女收集的139635份样本进行ABO和Rh血型分组。使用酶技术对6914名（5%）Rh阴性女性进行Rh抗体筛查。通过将数据分为四组，每组为期三年进行分析。
产前门诊就诊的女性人数稳步增加，但Rh阴性的频率保持在约5%。Rh阴性女性中的Rh免疫率从1981 - 1983年期间的3.1%降至1990 - 1992年期间的1.7%。孕妇中的发生率从0.16%降至0.09%，这具有统计学意义（p < 0.05）。Rh阴性女性中Rh免疫的发生率从首次妊娠时的0.4%增加到四次或更多次妊娠后的17.5%（p < 0.01）。在167名Rh免疫的女性中，只有15人之前接受过抗D免疫球蛋白治疗。
在过去12年中，Rh免疫的发生率有所下降，这可能归因于计划生育和抗D免疫球蛋白的广泛使用。然而，只有制定全面的Rh预防计划，才有可能完全消除新生儿Rh溶血病。
