摘要
目的探讨RhD阴性孕妇孕期管理对妊娠结局及新生儿的影响。方法选取2018年1月至12月在山东省淄博市桓台县人民医院产科进行孕期管理的75例RhD阴性孕妇作为观察组,选择同期住院的72例健康孕妇作为对照组,分析两组妊娠结局及RhD阴性抗体与ABO血型的关系。结果观察组中新生儿72例,死胎3例,均为单胎。相较于对照组,观察组中新生儿高胆红素血症检出率(22.22%)和早产发生率(30.56%)显著升高,差异有统计学意义(P <0.05)。两组死胎、新生儿窒息发生率、产后出血量、羊水粪染和剖宫产发生率比较,差异均无统计学意义(P> 0.05)。观察组72例分娩胎儿中,ABO血型相合者52例,不相合者20例,在血型不相合者中,相较于RhD抗体阴性发生率,抗体阳性率明显较高,差异有统计学意义(P <0.05)。20例母婴血型不相合中,胎儿死亡1例(5.00%),发生新生儿溶血16例(80.00%),剩下3例均存活,给予患儿输血、光照疗法、换血等治疗,均未见后遗症。结论针对RhD阴性孕妇,采用孕期治疗管理,积极给予宫内输血、血浆置换等综合治疗,必要时抽脐血检查,可提升围生儿的生存及生活质量,取得显著治疗效果,延长胎龄,具有临床应用价值。
Objective To investigate the effect of pregnancy management of Rhd-negative pregnant women on pregnancy outcome and newborn.Methods Seventy-five RhD-negative pregnant women who underwent pregnancy management in the obstetrics department of Huantai County People’s Hospital of Zibo City,Shandong province from January to December 2018 were selected as the observation group,and 72 healthy pregnant women who were hospitalized during the same period were selected as the control group to analyze the pregnancy outcome of the two groups and the relationship between RhD-negative antibodies and ABO blood group.Results There were 72 newborns and 3 stillbirths in the observation group,all of them were single fetus.Compared with the control group,the detection rate of neonatal hyperbilirubinemia(22.22%)and the incidence of premature delivery(30.56%)in the observation group were significantly increased(P<0.05).There was no significant difference between the two groups in the incidence of stillbirth,neonatal asphyxia,postpartum hemorrhage,amniotic fluid fecal staining and cesarean section(P>0.05).In the observation group,there were 52 cases with the same ABO blood group and 20 cases with the same ABO blood group and 20 cases with the same ABO blood group.Compared with the negative rate of RhD antibody,the positive rate of the antibody was significantly higher.The difference was statistically significant(P<0.05).Among the 20 cases,1 case of fetal death(5.00%),16 cases of neonatal hemolysis(80.00%)and 3 cases survived.No sequelae were found after transfusion,light therapy and blood exchange.Conclusion For RhD-negative pregnant women,treatment management during pregnancy,active intrauterine blood transfusion,plasma exchange and other comprehensive treatment,and cord blood extraction examination when necessary can improve the survival and quality of life of perinatal infants,obtain significant therapeutic effect,prolong gestational age,and have clinical application value.
作者
崔玉萍
CUI Yuping(Department of Obstetrics,Huantai County People's Hospital,Zibo City,Shandong Province,256400,China)
出处
《大医生》
2019年第2期55-56,共2页
Doctor
关键词
妊娠结局
新生儿
RHD阴性
孕期管理
孕妇
pregnancy outcome
newborn
RhD negative
pregnancy management
pregnant woman
