切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2018, Vol. 07 ›› Issue (01) : 9 -13. doi: 10.3877/cma.j.issn.2095-3259.2018.01.003

所属专题: 文献

专家论坛

胎母输血综合征的诊治
黄林环1, 罗艳敏1,()   
  1. 1. 510080 广州,中山大学附属第一医院妇产科
  • 收稿日期:2017-11-02 出版日期:2018-02-18
  • 通信作者: 罗艳敏

Diagnosis and therapy of fetomaternal hemorrhage syndrome

Linhuan Huang1, Yanmin Luo1()   

  • Received:2017-11-02 Published:2018-02-18
  • Corresponding author: Yanmin Luo
引用本文:

黄林环, 罗艳敏. 胎母输血综合征的诊治[J]. 中华产科急救电子杂志, 2018, 07(01): 9-13.

Linhuan Huang, Yanmin Luo. Diagnosis and therapy of fetomaternal hemorrhage syndrome[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2018, 07(01): 9-13.

胎母输血综合征是发生于妊娠期的并发症,目前病因不甚清楚,初期胎儿可代偿而无明显表现,失代偿会出现胎动减少或消失、胎心监护出现正弦曲线以及水肿胎等表现,可通过Kleihauer-Betke试验及流式细胞仪诊断。确诊病例需针对胎儿具体情况进行宫内输血或终止妊娠,及时纠正胎儿或新生儿贫血,提高围产儿的存活率,改善预后。

Fetomaternal hemorrhage syndrome is a complication occurring during pregnancy, and the etiology is not clear at present. Initially, the fetus can be compensated without obvious manifestations. At decompensation stage, fetal movement may reduce or disappear, sinusoidal fetal heart monitoring or fetal edema appear. The disease can be diagnosed by Kleihauer-Betke test and flow cytometry. According to the condition of the fetus, implement intrauterine blood transfusion or termination of pregnancy, correct fetal or neonatal anemia timely, which can improve perinatal survival rate and prognosis.

[1]
Singh P, Swanson T. Acute and chronic fetal anemia as a result of fetomaternal hemorrhage [J]. Case Rep Obstet Gynecol, 2014, 2014: 296463.
[2]
Yamada T, Morikawa M, Yamada T, et al. Changes in hemoglobin F levels in pregnant women unaffected by clinical fetomaternal hemorrhage [J]. Clin Chim Acta, 2013, 415: 124-127.
[3]
Stefanovic V. Fetomaternal hemorrhage complicated pregnancy: risks, identification, and management [J]. Curr Opin Obstet Gynecol, 2016, 28(2): 86-94.
[4]
Sueters M, Arabin B, Oepkes D. Doppler sonography for predicting fetaI anemia caused by massive fetomaternal hemorrhage [J]. Ultrasound Obstet Gynecol, 2003, 22(2): 186-189.
[5]
Rubod C, Deruelle P, Le Goueff F. Long-term prognosis for infants after massive fetomaternal hemorrhage [J]. Obstet Gynecol, 2007, 110(2 Pt 1): 256-260.
[6]
Wylie BJ, D′Alton ME. Fetomaternal hemorrhage [J]. Obstet Gynecol, 2010, 115(5): 1039-1051.
[7]
Bakas P, Liapis A, Giner M, et al. Massive fetomaternal hemorrhage and oxytocin contraction test: case report and review [J]. Arch Gynecol Obstet, 2004, 269(2): 149-151.
[8]
Subirá D, Uriel M, Serrano C, et al. Significance of the volume of fetomaternal hemorrhage after performing prenatal invasive tests[J]. Cytometry B Clin Cytom, 2011, 80(1): 38-42.
[9]
Meleti D, De Oliveira LG, Araujo Ju ′nior E, et al. Evaluation of passage of fetal erythrocytes into maternal circulation after invasive obstetric procedures [J]. J Obstet Gynaecol Res, 2013, 39(9): 1374-1382.
[10]
O’Leary BD, Walsh CA, Fitzgerald JM, et al. The contribution of massive fetomaternal hemorrhage to antepartum stillbirth: a 25-year cross-sectional study [J]. Acta Obstet Gynecol Scand, 2015, 94(12): 1354-1358.
[11]
Faber VJ, Klumper FJ, Scherjon S, et al. Severe preeclampsia and HELLP syndrome after massive fetomaternal hemorrhage following blunt abdominal trauma [J]. Pregnancy Hypertens, 2011, 1(3-4): 197-199.
[12]
Farina A, Hasegawa J, Raffaelli S, et al. The association between preeclampsia and placental disruption induced by chorionic villous sampling [J]. Prenat Diagn, 2010, 30(6): 571-574.
[13]
Mirza FG, Thaker HM, Flejter WL, et al. Fetomaternal hemorrhage following placement of an intrauterine pressure Catheter: Report of a New Association [J]. Case Rep Obstet Gynecol, 2015, 2015: 348279.
[14]
Giacoia GP. Severe fetomaternal hemorrhage: a review [J]. Obstet Gynecol Surv, 1997, 52(6): 372-380.
[15]
Bellussi F, Perolo A, Ghi T, et al. Diagnosis of severe fetomaternal hemorrhage with fetal cerebral doppler: Case series and systematic review [J]. Fetal Diagn Ther, 2017, 41(1): 1-7.
[16]
Christensen RD, Lambert DK, Baer VL, et al. Severe neonatal anemia from fetomaternal hemorrhage: report from a multihospital health-care system [J]. J Perinatol. 2013, 33(6): 429-434.
[17]
Stroustrup A, Plafkin C, Savitz DA. Impact of physician awareness on diagnosis of fetomaternal hemorrhage [J]. Neonatology, 2014, 105(4): 250-255.
[18]
Suzuki S, Kuwajima T, Murata T, et al. A case of maternal reaction due to fetomaternal transfusion [J]. J Nippon Med Sch, 2003, 70(5): 447-448
[19]
Umazume T, Morikawa M, Yamada T, et al. Long-term persistent fetomaternal hemorrhage [J]. Clin Case Rep, 2015, 3(11): 916-919.
[20]
Kim YA, Makar RS. Detection of fetomaternal hemorrhage [J]. Am J Hematol, 2012, 87(4): 417-423.
[22]
Solomonia N, Playforth K, Reynolds EW. Fetal-maternal hemorrhage: a case and literature review [J]. AJP Rep, 2012, 2(1): 7-14.
Maier JT, Schalinski E, Schneider W, et al. Fetomaternal hemorrhage (FMH), an update: review of literature and an illustrative case [J]. Arch Gynecol Obstet, 2015, 292(3): 595-602.
[23]
Austin E, Bates S, Silva M, et al. BCSH Blood Transfusion and General Haematology Task Forces: The estimation of fetomaternal haemorrhage[R]. Guidelines, 2009: 1-23.
[24]
Urgessa F, Tsegaye A, Gebrehiwot Y, et al. Assessment of feto-maternal hemorrhage among rhesus D negative pregnant mothers using the kleihauer-betke test (KBT) and flow cytometry (FCM) in Addis Ababa, Ethiopia[J]. BMC Pregnancy Childbirth, 2014, 14: 358-366.
[25]
赵友平,黄醒华. 胎母输血综合征对围产儿影响的研究进展 [J].中华妇产科杂志,2008, 43(8):632-634.
[26]
Mari G, Norton ME, Stone J, et al. Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: the fetus at risk for anemia-diagnosis and management [J]. Am J Obstet Gynecol, 2015, 212(6): 697-710.
[27]
Giannina G, Moise KJ Jr, Dorman K. A simple method to estimate volume for fetal intravascular transfusions [J]. Fetal Diagn Ther, 1998, 13(2): 94-97.
[28]
Rubod C, Houfflin V, Belot F, et al. Successful in utero treatment of chronic and massive fetomaternal hemorrhage with fetal hydrops [J]. Fetal Diagn Ther, 2006, 21(5): 410-413.
[29]
Detti L, Oz U, Guney I, et al. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses. Doppler ultrasound velocimetry for timing the second intrauterine transfusion in fetuses with anemia from red cell alloimmunization [J]. Am J Obstet Gynecol, 2001, 185(5): 1048-1051.
[30]
Greiss MA, Armstrong-Fisher SS, Perera WS, et al. Semiautomated data analysis of flow cytometric estimation of fetomaternal hemorrhage in D-women [J]. Transfusion, 2002, 42(8): 1067-1078.
[31]
Naulaers G, Barten S, Vanhole C, et al. Management of severe neonatal anemia due to fetomaternal transfusion [J]. Am J Perinatol, 1999, 16(4): 193-196.
[32]
Kadooka M, Kato H, Kato A, et al. Effect of neonatal hemoglobin concentration on long-term outcome of infants affected by fetomaternal hemorrhage [J]. Early Hum Dev, 2014, 90(9): 431-434.
[33]
De Almeida V, Bowman JM. Massive fetomaternal hemorrhage: Manitoba experience [J]. Obstet Gynecol, 1994, 83(3): 323-328.
[34]
Lindenburg IT, van Klink JM, Smits-Wintjens VE, et al. Long-term neurodevelopmental and cardiovascular outcome after intrauterine transfusions for fetal anaemia: a review[J]. Prenat Diagn, 2013, 33(9): 815-822.
[35]
Kecskes Z. Large fetomaternal hemorrhage: clinical presentation and outcome [J]. J Matern Fetal Neonatal Med, 2003, 13(2): 128-132.
[1] 高静, 严学倩, 及月茹, 郝淼旺, 刘苍春. 胃癌患者以慢性贫血为首发表现的高危因素Logistic分析[J]. 中华普外科手术学杂志(电子版), 2023, 17(05): 534-537.
[2] 李君, 范铁艳, 牛鑫鑫, 陈虹. 肝移植后他克莫司致缺铁性贫血一例[J]. 中华移植杂志(电子版), 2023, 17(03): 169-170.
[3] 罗来邦, 王绪杨, 胡续光, 张友福, 徐志丹. 宏基因组二代测序早期筛查肝移植术后人类微小病毒B19感染临床研究[J]. 中华移植杂志(电子版), 2022, 16(06): 346-352.
[4] 陈善良, 赵霜梅, 许莉, 厉泉, 苗强, 李敏, 李红昕, 刘天起. 心脏移植术后人类微小病毒B19感染致纯红细胞再生障碍性贫血三例并文献复习[J]. 中华移植杂志(电子版), 2022, 16(05): 299-301.
[5] 赵爽, 马梁明, 朱秋娟, 贡蓉, 高志林, 田卫伟, 王涛. 不同预处理方案对重型再生障碍性贫血患者单倍体造血干细胞移植的疗效分析[J]. 中华移植杂志(电子版), 2022, 16(04): 224-230.
[6] 中华医学会器官移植学分会, 国家肾脏移植质控中心. 肾移植受者人类微小病毒B19感染临床诊疗技术规范(2022版)[J]. 中华移植杂志(电子版), 2022, 16(04): 193-200.
[7] 李芸芸, 吴涛, 毛东锋, 鱼玲玲, 刘文慧. 轻型β-地中海贫血供者异基因造血干细胞移植治疗重型再生障碍性贫血1例[J]. 中华细胞与干细胞杂志(电子版), 2023, 13(02): 84-86.
[8] 樊佩琦, 闫燕, 李晓霞, 武玲宇, 郭罡玲, 李静, 王利华. 2020年山西省腹膜透析患者贫血的流行病学调查及相关因素分析[J]. 中华肾病研究电子杂志, 2023, 12(03): 121-126.
[9] 俞珊, 李志明, 段浩凯, 杨荔慧, 刘银萍, 王涛. 慢性肾脏病合并肺结核患者抗结核治疗转归相关因素分析[J]. 中华肾病研究电子杂志, 2022, 11(04): 207-211.
[10] 尤燕华, 胡玉清, 梁萌. 肌注维生素D2治疗维持性血液透析患者25羟维生素D缺乏的临床观察[J]. 中华肾病研究电子杂志, 2022, 11(04): 202-206.
[11] 王晓丽, 刘莹莹, 林少华, 范颖. 北京地区妊娠合并轻型地中海贫血六例临床分析[J]. 中华临床医师杂志(电子版), 2023, 17(02): 227-231.
[12] 赵洁, 王岚, 杨红枚, 何屹, 袁红. 异基因造血干细胞移植后并发自身免疫性溶血性贫血患者产生类抗体血清学检测方法及输血策略[J]. 中华临床医师杂志(电子版), 2022, 16(05): 452-456.
[13] 温洁, 陈丹青. 妊娠合并缺铁性贫血与产后出血的管理[J]. 中华产科急救电子杂志, 2022, 11(04): 217-221.
[14] 张丹, 颜新生, 张李涛, 张真路, 王栋. 利用质量工具减少地中海贫血基因检测复查率[J]. 中华临床实验室管理电子杂志, 2023, 11(02): 79-83.
[15] 刘秀丽, 梁倩文, 栾艺, 何川疆, 胡慧灵, 段朝晖. RDW、MCV、MCH联合筛查区分缺铁性贫血和地中海贫血携带者的应用价值[J]. 中华临床实验室管理电子杂志, 2022, 10(04): 199-203.
阅读次数
全文


摘要