Zimmermann R, Tuchschmid P, Duc G, Gmür J
Klinik für Geburtshilfe, Departement für Frauenheilkunde, Universität Zürich.
Schweiz Med Wochenschr. 1993 Sep 4;123(35):1655-61.
Alloimmune thrombocytopenia (AIT) in fetuses and newborn, a disease resembling Rh incompatibility, is caused by transplacental transfer of an IgG-class antibody against fetal platelets. In humans five different platelet antigen systems are so far known which lead to AIT. The disease occurs in 1:2000-1:5000 deliveries. In contrast to Rh disease, immunization occurs in the first pregnancy in the majority of cases. The main significance of AIT lies in the occurrence of fetal (-10%) and neonatal (-20%) intracranial hemorrhage. Newborns are treated with compatible platelets, if necessary in combination with immunoglobulins. The high rate of fetal intracranial hemorrhage justifies therapy during pregnancy as well. Antenatal measures include treatment of the mother with high-dose immunoglobulin, treatment of the fetus with immunoglobulin by cordocentesis, and fetal platelet transfusions. However, all therapeutic measures involving the fetus remain in the experimental stage at present. International cooperative studies are necessary to evaluate cost-benefit of intervention during pregnancy.
胎儿及新生儿同种免疫性血小板减少症（AIT）是一种类似于Rh血型不相容的疾病，由针对胎儿血小板的IgG类抗体经胎盘转移所致。目前已知在人类中有五种不同的血小板抗原系统可导致AIT。该病在每2000 - 5000次分娩中出现1例。与Rh疾病不同，大多数情况下在首次妊娠时就会发生免疫。AIT的主要危害在于胎儿（-10%）和新生儿（-20%）颅内出血的发生。必要时，新生儿采用相容性血小板治疗，可联合使用免疫球蛋白。胎儿颅内出血的高发生率也证明孕期治疗的合理性。产前措施包括给母亲大剂量免疫球蛋白治疗、经脐静脉穿刺给胎儿免疫球蛋白治疗以及胎儿血小板输注。然而，目前所有涉及胎儿的治疗措施仍处于实验阶段。有必要开展国际合作研究以评估孕期干预的成本效益。
