Moise K J
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas 77030.
West J Med. 1993 Sep;159(3):318-24.
Having direct access to the fetoplacental circulation by ultrasound-directed needle puncture has led to therapeutic interventions for fetal anemia and thrombocytopenia. Most cases of red cell alloimmunization associated with fetal anemia are caused by the antibody to the D red cell antigen. The intravascular transfusion of red cells to a hydropic fetus in such cases has notably improved survival. Nonimmune hydrops fetalis due to maternal parvovirus infection has also been treated successfully with the intravascular transfusion of red cells, whereas fetomaternal hemorrhage has not proved amenable to such therapy. Sensitization to the PLA-1 platelet antigen is the most common cause of fetal thrombocytopenia in maternal platelet alloimmunization. Fetal platelet transfusions have not proved to be a practical therapeutic modality for this disorder owing to the short half-life of the platelets. Platelets transfusions to the fetus just before delivery may avert the need for cesarean section in cases of severe thrombocytopenia.
通过超声引导下的针刺直接进入胎儿-胎盘循环，已实现了针对胎儿贫血和血小板减少症的治疗干预。与胎儿贫血相关的大多数红细胞同种免疫病例是由针对D红细胞抗原的抗体引起的。在这种情况下，对水肿胎儿进行红细胞血管内输血显著提高了存活率。由于母体细小病毒感染导致的非免疫性胎儿水肿，也已通过红细胞血管内输血成功治疗，而胎儿-母体出血尚未证明适用于此类治疗。对PLA-1血小板抗原的致敏是母体血小板同种免疫中胎儿血小板减少症的最常见原因。由于血小板半衰期短，胎儿血小板输血尚未证明是治疗这种疾病的实用方法。在分娩前对胎儿进行血小板输血，可能避免在严重血小板减少症病例中进行剖宫产。
