妊娠合并RH阴性48例临床分析

目的探讨RH阴性孕妇孕期处理、妊娠结局及随访情况。方法回顾分析2008年6月～2010年5月笔者医院分娩RH阴性孕妇48例临床资料。结果 RH血型不合发生率0.52%(48/9320),单胎46例,双胎2例;12例孕妇抗D抗体阳性,其中2例初产妇,10例经产妇;44例活婴(含1例双胎),其中1例新生儿死亡,1例遗留后遗症;5例死胎(含1例双胎)均为抗D效价阳性者;总的新生儿治愈率95.45%(42/44)。结论系统孕期管理与治疗是预防RH同种免疫与胎儿或新生儿溶血病的关键。当母亲抗体效价≥1∶16,孕龄达32周,有新生儿重症监护室(neonatal intensive care unit,NICU)条件时可考虑择时终止妊娠。及时换血能显著改善新生儿溶血的预后,对提高产科质量有重要意义。

Clinical Analysis of 48 RH-negative Pregnant Women. Li Lijie, Zheng Yanmei

Objective To investigate the clinical treatment and outcome of RH-negative pregnant women,and to analyze the follow-up works.Methods Data of 48 RH-negative pregnant women born in our hospital from June 2008 to May 2010 were collected and analyzed retrospectively.Results The incidence of RH-nagative blood type incompatibility was 0.52%(48/9320).Among the above patients,46 cases were single pregnancy and 2 cases were twins.Anti-D IgG was identified in 12 cases,and 2 of them were primipara,10 were multipara.The clinical outcomes of 44 fetuses(newborns) from RH-negative pregnant women were observed.One case died several days after birth,and 1 case showed some abnormality.Five stillbirth fetuses were all from positive anti-D pregnant women.The total newborn recovery rate was 95.45%(42/44).Conclusion Systematic managements and treatments are crucial for preventing RH isoimmunization and fetal or neonatal hemolytic disease.The screening and titer detection of anti-D IgG in RH-negative pregnant women are valuable in the prediction and treatment of hemolytic disease of newborn.