Fischer K
Zentralinstitut für Transfusionsmedizin, Hamburg, BRD.
Infusionsther Transfusionsmed. 1993 Jun;20 Suppl 2:64-9.
Prenatal diagnosis and management of the hemolytic disease of the newborn are based on previous history, measurement of maternal antibody potency, amniotic fluid analysis, and fetal blood sampling. However, amniocentesis and cordocentesis are invasive procedures and bear the substantial risk of an increase in maternal antibody titer with subsequently more severely affected babies. Therefore, we determined the functional activity of the maternal antibodies by a modified monocyte-monolayer assay in comparison to the hemagglutination titer of sensitized red blood cells using selected sera with rheumatoid factor as human anti-IgG (RF titer). IgG antibodies (e.g., anti-A, -B), which can react with extraerythrocytic antigens, do not cause fetal death. Massive fetomaternal hemorrhage can induce hydrops fetalis and--in case of 0/A or 0/B blood group constellation between mother and child--may suggest a misleading diagnosis of AB0 hemolytic disease. Efficacy and costs of the pre- and postpartal Rh prophylaxis in Germany are calculated.
新生儿溶血病的产前诊断和管理基于既往病史、母体抗体效价测定、羊水分析和胎儿血液采样。然而，羊膜穿刺术和脐带穿刺术是侵入性操作，存在母体抗体效价升高以及随后婴儿受更严重影响的重大风险。因此，我们通过改良的单核细胞单层试验测定母体抗体的功能活性，并与使用含有类风湿因子作为人抗IgG的选定血清的致敏红细胞血凝效价（RF效价）进行比较。能与红细胞外抗原发生反应的IgG抗体（如抗A、抗B）不会导致胎儿死亡。大量胎儿-母体出血可诱发胎儿水肿，并且在母婴血型为0/A或0/B组合的情况下，可能提示对ABO溶血病的误诊。计算了德国产前和产后Rh预防的效果和成本。
