妊娠合并RH阴性48例临床分析

摘要

Objective To investigate the clinical treatment and outcome of RH - negative pregnant women, and to analyze the fallow - up works. Methods Data of 48 RH - negative pregnant women bom 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 IgC 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.%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.