【摘要】 目的Rh血型不合是我国新生儿溶血病的主要原因之一,其病情往往较重甚至出现胎儿水肿,胎死宫内。本研究主要探讨Rh阴性孕妇孕期处理及妊娠结局。方法回顾分析1999年1月至2004年12月我院发现的Rh阴性孕妇44例,观察其临床特点,孕期处理及妊娠结局。随机抽取同期分娩的无合并症并发症妇女44例作为对照组。结果Rh阴性孕妇的羊水粪染,新生儿窒息,低体重儿,新生儿转入重症监护室及产后出血的发生率分别为11.36%,4.55%,11.36%,9.09%,13.6%与对照组比较无显著差异。早产及新生儿高胆红素血症的发生率均为15.9%,与对照组比较有显著差异。经多元回归分析发现发生血型不合的危险因素为死胎史及抗-D抗体效价大于1∶16。结论对Rh阴性孕妇进行系统管理(包括产检常规查Rh血型,定期检测抗-D抗体效价,系列B超检查,羊水检查及脐带穿刺)及时治疗(包括抗-D免疫球蛋白,宫内输血,及时终止妊娠)可明显改善围生儿预后,对提高产科质量有重要意义。更多还原

【Abstract】 Objective: Rhesus blood group incompatibility is the major cause of neonatal hemolytic diseases in China .CDE incompatibility usually causes severe disease and results in significant anemia. In our study, we evaluated the management and pregnant outcomes of Rh-negative women. Methods: 44 cases of Rh-negative pregnant women were collected retrospectively, compared with 44 cases Rh-positive women as the control group from January 1999 to December 2004.Results:We found that in Rh-negative group the incidences of aminotic fluid meconium staining, neonatal asphyxia, neonatal intensive care unit admission ,low birth weight and postpartum hemorrhage were 11. 36%,4.55%,11.36%,9.09%,13.6% respctively, compared to the control group there were 15.9%,4.55%,2.27%,6.82%,4.55%, there were no significant differences between two groups. But the incidences of preterm birth and hyperbilirubinemia in Rh-negative group were both 15.9%,higher than the control group(2.27%).And the risk fators for hemolytic disease were fetal death and the anti-D antibody titer above 1:16.Conclusion:The study demonstrate that systematic managemet (incuding routine test for the presence or absence of D antigen in pregnant women,series test of anti-D antibody titer and ultrasonography, amniocentesis and cordocentesis) and timely treatment(including anti-D immunoglobulin, plasmapheresis intrauterine trasfusion and delivery) can improve the perinal outcomes of Rh-negative women.更多还原