胎母输血综合征(FMH)发病隐匿,早期诊断困难,常引起胎儿水肿、严重贫血,甚至胎死宫内,从而导致不良围生期结局.FMH发生病因尚未明确,目前认为可能由于胎儿脐动脉与绒毛间隙间形成压力差,进而造成胎儿血液直接进入绒毛间隙并逆流入母体血液循环所致.胎动减少或消失是FMH最常见的产前临床表现.目前用于检测FMH的方法有:红细胞酸洗脱法(KB试验)、母血胎儿血红蛋白含量测定、母血清甲胎蛋白测定、流式细胞仪计数、免疫荧光技术及超声多普勒检查,其中,临床以KB试验和超声检查最为常用.治疗方案应根据胎龄、病情严重程度制订.围生期的预后取决于FMH的严重程度以及输血量,但关于FMH的远期预后有待进一步研究.%Fetomaternal hemorrhage(FMH)is occult and difficult to diagnose during early stage,it often causes fetal hydrops,severe anemia and even intrauterine fetal death,resulting in adverse perinatal outcomes.The etiology is not very clear,and it is thought that the pressure difference between the fetal umbilical artery and the villus space may cause fetal blood to enter the villus space directly and counter flow into the maternal blood circulation.Fetal movement reduction or disappearance is the most common clinical manifestation of FMH.The current methods for detecting FMH include:red blood cells elution method(KB test),determination of fetal hemoglobin in maternal blood,alpha fetoprotein in maternal serum, flow cytometry,immunofluorescence technique and Doppler ultrasound examination, among which,KB test and ultrasound examination are the most commonly used in clinical.The treatment should be based on the gestational age and severity of the disease.The prognosis of perinatal depends on the severity of FMH and the amount of blood transfusion,however,the long-term prognosis of FMH needs further study.
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