摘要
目的:探讨Rh阴性孕妇产前免疫血液学检查结果及应用抗-D免疫球蛋白对母婴结局的影响。方法:选取2016年5月-2020年6月本院Rh阴性孕妇临床资料98例进行回顾性分析,均在产前行免疫血液学检查,根据有无应用抗-D免疫球蛋白分为应用组52例与未应用组46例,对比产后出血量、新生儿Apgar评分、妊娠结局(新生儿感染、新生儿贫血、新生儿高胆红素血症、早产、死胎、新生儿RhD阴性血型)及新生儿溶血病(HDN)发生率。结果:98例Rh阴性孕妇中检出D阴性93例(94.9%)、变异性D阴性5例(5.1%);D阴性中ccee表现型50例(53.8%)、Ccee表现型33例(35.5%)、CCee表现型6例(6.5%)、ccEe表现型3例(3.2%)、CcEe表现型1例(1.1%)。93例Rh(D)阴性孕妇中检出抗-D抗体阳性18例(19.4%),检出率应用组(2例,3.9%)低于未应用组(16例,34.8%)(χ2=15.580,P<0.05)。应用组产后出血量小于未应用组,新生儿Apgar评分高于未应用组,新生儿贫血、新生儿高胆红素血症及早产发生率、HDN总发生率低于未应用组(均P<0.05)。两组新生儿感染、死胎及新生儿RhD阴性血型发生率无差异(P>0.05)。结论:Rh阴性孕妇的Rh抗原以ccee表现型多见,其次为Ccee表现型,可通过注射抗-D免疫球蛋白避免同种免疫产生抗-D抗体,改善母婴结局。
Objective:To investigate the results of prenatal maternal immunohematology of Rh-negative pregnant women,and to study the influence of anti-D immunoglobulin application on the maternal and infant outcomes.Methods:The clinical data of 98 Rh-negative pregnant women from May 2016 to June 2020 were analyzed retrospectively.All of these women had undergone immunohematological examination before delivery.According to whether anti-D immunoglobulin application,these women were divided into group A(52 women given anti-D immunoglobulin)and group B(46 not given anti-D immunoglobulin).The postpartum hemorrhage rate,neonatal Apgar score,pregnancy outcomes(neonatal infection,neonatal anemia,neonatal hyperbilirubinemia,and the incidences of premature birth,stillbirth,neonatal RhD-negative blood type,and neonatal hemolytic disease of the newborn(HDN)were compared between the two groups.Results:In 98 Rh-negative pregnant women,there were 93(94.9%)women with D negative,5(5.1%)women with variability D negative.In the D negative women,there were 50(53.8%)CCEE phenotype,33(35.5%)women with CCEE phenotype,6(6.5%)women with CCEE phenotype,3(3.2%)women with CCEE phenotype,and 1(1.1%)woman with CCEE phenotype.Among 93 Rh(D)negative pregnant women,18 cases(19.4%)were positive for anti-D antibody,and the detection rate of the women in group A was 3.9%(2 cases),which was significant lower than that(34.8%,16 cases)of the women in group B(χ2=15.580,P<0.05).The postpartum blood loss of the women in group A was significant lower than that of the women in group B,the Apgar score of the neonates in group A was significant higher than that of the neonates in group B.The incidences of neonatal anemia and hyperbilirubinemia,preterm delivery,and the total incidence of HDN in group A were significant lower than those in group B(all P<0.05).There were no significant differences in the incidences of neonatal infection,stillbirth,and RhD negative blood of newborns between the two groups(P>0.05).Conclusion:The Rh antigen of Rh-negative pregnant women is
作者
江梅
谢晓绘
张晓菊
周丹
JIANG Mei;XIE Xiaohui;ZHANG Xiaoju;ZHOU Dan(The first People's Hospital of Neijiang, Sichuan Province, 641000)
出处
《中国计划生育学杂志》
2021年第8期1722-1726,共5页
Chinese Journal of Family Planning
基金
四川省内江市重点科学技术项目(2020-03)。
关键词
Rh阴性血型孕妇
免疫血液学
抗-D免疫球蛋白
母婴结局
Pregnant women with Rh negative blood type
Immunohematology
Anti-D immunoglobulin
Maternal and infant outcomes
