切换至 "中华医学电子期刊资源库"

中华妇幼临床医学杂志(电子版) ›› 2018, Vol. 14 ›› Issue (03) : 249 -255. doi: 10.3877/cma.j.issn.1673-5250.2018.03.001

所属专题: 文献

专家约稿

母婴Rh血型不合胎儿和新生儿溶血病相关临床问题研究
敖雪1, 谭世桥1, 余海燕1,()   
  1. 1. 610041 成都,四川大学华西第二医院妇产科、出生缺陷与相关妇儿疾病教育部重点实验室
  • 收稿日期:2017-11-10 修回日期:2018-02-22 出版日期:2018-06-01
  • 通信作者: 余海燕

Research status on clinical problems of rhesus maternal-fetal blood group incompatibility hemolytic disease of fetus and newborn

Xue Ao1, Shiqiao Tan1, Haiyan Yu1,()   

  1. 1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2017-11-10 Revised:2018-02-22 Published:2018-06-01
  • Corresponding author: Haiyan Yu
  • About author:
    Corresponding author: Yu Haiyan, Email:
引用本文:

敖雪, 谭世桥, 余海燕. 母婴Rh血型不合胎儿和新生儿溶血病相关临床问题研究[J]. 中华妇幼临床医学杂志(电子版), 2018, 14(03): 249-255.

Xue Ao, Shiqiao Tan, Haiyan Yu. Research status on clinical problems of rhesus maternal-fetal blood group incompatibility hemolytic disease of fetus and newborn[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2018, 14(03): 249-255.

母婴Rh血型不合胎儿和新生儿溶血病(Rh-HDFN),是胎儿或新生儿同种被动免疫溶血性贫血最常见原因之一。Rh-HDFN导致的胎儿或新生儿病情危重,可引起胎儿严重贫血、水肿、心力衰竭、死胎,或导致新生儿核黄疸及死亡等,而幸存Rh-HDFN新生儿,则可能遗留智力发育不全、运动功能障碍等神经系统后遗症。临床对于Rh-HDFN的早期诊断、及时治疗与胎儿及新生儿预后的关系紧密相关。Rh-HDFN的产前预防,越来越受到产科临床的关注。笔者拟针对Rh-HDFN临床相关问题的最新研究进展进行阐述。

Rhesus maternal-fetal blood group incompatibility hemolytic disease of fetus and newborn (Rh-HDFN) is one of the most common causes of passive immune hemolytic anemia in fetuses or neonates. Rh-HDFN is critically ill, which can cause severe fetal anemia, edema, heart failure, stillbirth and neonatal kernicterus, death. Survival newborns with Rh-HDFN may suffer mental retardation, motor disorders and other neurological sequelae. Early diagnosis of Rh-HDFN and timely treatment are closely related to the prognosis of fetus and newborn, which has attracted more and more clinical attention. This article focuses on related clinical issues and the latest research advance in Rh-HDFN.

[1]
Shao CP, Mass JH, Su YQ, et al. Molecular background of Rh D-positive, D-negative, D(el) and weak D phenotypes in Chinese[J]. Vox Sang, 2002, 83(2): 156-161.
[2]
Moise KJ Jr, Argoti PS. Management and prevention of red cell alloimmunization in pregnancy: a systematic review[J]. Obstet Gynecol, 2012, 120(5): 1132-1139.
[3]
邵超鹏,秦建江,孙国栋,等. Rh阳性个体RHD杂合性分析[J]. 中华医学遗传学杂志,2011, 28(1): 29-32.
[4]
Achargui S, Benchemsi N. A quantitative determination of IgG anti-D subclasses by Elisa in hemolytic disease of the newborn[J]. Transfus Clin Biol, 2003, 10(4): 284-291.
[5]
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 75: management of alloimmunization during pregnancy[J]. Obstet Gynecol, 2006, 108(2): 457-464.
[6]
韩梅宁,马兆霞,张明刚. 126例Rh阴性妇女D抗原刺激后血清抗体分析[J]. 现代检验医学杂志,2009, 24(2): 125-127.
[7]
苏奶助,沈雨青,龚君顺,等. 厦门地区RhD阴性孕产妇血清学表型及不规则抗体监测的研究[J]. 临床血液学杂志,2016, 29(3): 471-473.
[8]
Rubod C, Deruelle P, Le Goueff F, et al. Long-term prognosis for infants after massive fetomaternal hemorrhage[J]. Obstet Gynecol, 2007, 110(2 Pt 1): 256-260.
[9]
Kulinska R. Haemolytic disease of the fetus and newborn/HDFN/timing in pregnant women and prophylaxis[J]. Akush Ginekol (Sofiia), 2014, 53(2): 58-63.
[10]
Shao CP, Xu H, Xu Q, et al. Antenatal Rh prophylaxis is unnecessary for " Asia type" DEL women[J]. Transfus Clin Biol, 2010, 17(4): 260-264.
[11]
Wang M, Wang BL, Xu W, et al. Anti-D alloimmunisation in pregnant women with DEL phenotype in China[J]. Transfus Med, 2015, 25(3): 163-169.
[12]
Kapur R, Della Valle L, Sonneved M, et al. Low anti-RhD IgG-Fc-fucosylation in pregnancy: a new variable predicting severity in haemolytic disease of the fetus and newborn[J]. Br J Haematol, 2014, 166(6): 936-945.
[13]
危燕芬,严康峰,汪丽娟,等. 单核单层实验在Rh系统新生儿溶血病中的应用[J]. 国际检验医学杂志,2008, 29(6): 496-497, 500.
[14]
Mari G, Norton ME, Stone J. et al. Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: the fetus at risk for anemia-diagnosis and management[J]. Am J Obstet Gynecol, 2015, 212(6): 697-710.
[15]
Mari G, Deter RL, Carpenter RL, et al. Non-invasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses[J]. N Engl J Med, 2000, 342(1): 9-14.
[16]
Maisonneuve E, Jayot A, Friszer S, et al. Accuracy of middle cerebral artery doppler assessment between 34 and 37 weeks in fetuses with red cell alloimmunization[J]. Fetal Diagn Ther, 2017, 42(3): 225-231.
[17]
Avent ND, Reid ME. The Rh blood group system: a review[J]. Blood, 2000, 95(2): 375-387.
[18]
赵黎,黄醒华. 孕妇输血史与围产儿Rh溶血病的关系[J]. 中华妇产科杂志,1999, 34(4): 45-46.
[19]
De Haas M, Thurik FF, van der Ploeg CP, et al. Sensitivity of fetal RhD screening for safe guidance of targeted anti-D immunoglobulin prophylaxis: prospective cohort study of a nationwide programme in the netherlands[J]. BMJ, 2016, 355(3): i5789.
[20]
Mackie FL, Hemming K, Allen S, et al. The accuracy of cell-free fetal DNA-based non-invasive prenatal testing in singleton pregnancies: a systematic review and bivariate Meta-analysis[J]. BJOG, 2017, 124(1): 32-46.
[21]
Soothill PW, Finning K, Latham T, et al. Use of cffDNA to avoid administration of anti-D to pregnant women when the fetus is RhD-negative: implementation in the NHS[J]. BJOG, 2015, 122(12): 1682-1686.
[22]
Fung Kee Fung K, Eason E, Crane J, et al. Prevention of Rh alloimmunization[J]. J Obstet Gynaecol Can, 2003, 25(9): 765-773.
[23]
Qureshi H, Massey E, Kirwan D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn[J]. Transfus Med, 2014, 24(1): 8-20.
[24]
Delaney M, Matthews DC. Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn[J]. Hematology Am Soc Hematol Educ Program, 2015, 2015: 146-151.
[25]
Harrod KS, Hanson L, Vandevusse L, et al. Rh negative status and isoimmunization update: a case-based approach to care[J]. J Perinat Neonatal Nurs, 2003, 17(3): 166-178.
[26]
Lindenburg IT, van Kamp IL, van Zwet EW, et al. Increased perinatal loss after intrauterine transfusion for alloimmune anaemia before 20 weeks of gestation[J]. BJOG, 2013, 120(7): 847-852.
[27]
Papantoniou N, Sifakis S, Antsaklis A. Therapeutic management of fetal anemia: review of standard practice and alternative treatment options[J]. J Perinat Med, 2013, 41(1): 71-82.
[28]
van Klink JM, van Veen SJ, Smits-Wintjens VE, et al. Immunoglobulins in neonates with rhesus hemolytic disease of the fetus and newborn:long-term outecome in a randomized trial[J]. Fetal Diagn Ther, 2016, 39(3): 209-313.
[29]
Louis D, More K, Oberoi S, et al. Intravenous immunoglobulin in isoimmune haemolytic disease of newborn: an updated systematic review and Meta-analysis[J]. Arch Dis Child Fetal Neonatal Ed, 2014, 99(4): 325-331.
[30]
Scheier M, Hernandez-Andrade E, Fonseca EB, et al. Prediction of severe fetal anemia in red blood cell alloimmunization after previous intrauterine transfusions[J]. Am J Obstet Gynecol, 2006, 195(6): 1550-1556.
[31]
Payam Khaja Pasha R, Shokri F. Immunologic basis and immunoprophylaxis of Rh(D) induced hemolytic disease of the newborn(HDN)[J]. Iran J Immunol, 2008, 5(4): 181-189.
[1] 王宏宇. 固定与活动平台假体在全膝关节置换术中的应用价值[J]. 中华关节外科杂志(电子版), 2023, 17(06): 871-876.
[2] 许正文, 李振, 侯振扬, 苏长征, 朱彪. 富血小板血浆联合植骨治疗早期非创伤性股骨头坏死[J]. 中华关节外科杂志(电子版), 2023, 17(06): 773-779.
[3] 高玲, 于哲, 范然, 臧银善. 外周血细胞计数比值评估类风湿关节炎疗效的价值[J]. 中华关节外科杂志(电子版), 2023, 17(05): 642-647.
[4] 王泽勇, 覃健. 白细胞含量对富血小板血浆治疗运动系统损伤的影响[J]. 中华关节外科杂志(电子版), 2023, 17(05): 684-688.
[5] 陈甜甜, 王晓东, 余海燕. 双胎妊娠合并Gitelman综合征孕妇的妊娠结局及文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 559-568.
[6] 居晓庆, 金蕴洁, 王晓燕. 剖宫产术后瘢痕子宫患者再次妊娠阴道分娩发生子宫破裂的影响因素分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 575-581.
[7] 王蓓蓓, 董启秀, 郗红燕, 于庆云, 张丽君, 式光. 早孕期孕妇药物流产失败的影响因素分析与构建相关预测模型及其对药物流产成功的预测价值[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 588-594.
[8] 陈絮, 詹玉茹, 王纯华. 孕妇ABO血型联合甲状腺功能检测对预测妊娠期糖尿病的临床价值[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 604-610.
[9] 周梦玲, 薛志伟, 周淑. 妊娠合并子宫肌瘤的孕期变化及其与不良妊娠结局的关系[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 611-615.
[10] 张海涛, 康婵娟, 翟静洁. 胰管支架置入治疗急性胆源性胰腺炎效果观察[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 654-657.
[11] 陈垚, 徐伯群, 高志慧. 改良式中间上入路根治术治疗甲状腺癌的有效性安全性研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 619-622.
[12] 黎熊, 曹永宽. 不同远切缘距离的ISR在局部进展期直肠癌新辅助治疗后的临床研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 443-446.
[13] 冯树森, 张东成, 郭奇, 张皓露, 陈阔. 两种手术方法对急性阑尾炎患者的临床疗效及对炎性因子的影响比较[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 447-450.
[14] 卜晓沛, 刘冰, 张江华, 赵臣, 张金江, 尚培中. 子宫直肠瘘1例报告[J]. 中华普外科手术学杂志(电子版), 2023, 17(04): 469-470.
[15] 王峰杰, 王礼光, 廖珊, 刘颖, 符荣党, 陈焕伟. 腹腔镜右半肝切除术治疗肝癌的安全性与疗效[J]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 517-522.
阅读次数
全文


摘要