შეჯამება
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
Risk factors
- antecedentes de un feto RhD positivo en una madre RhD negativa
- hemorragia fetomaterna
- procedimientos fetales invasivos
- traumatismo placentario
- aborto
- multiparidad
- omisión de la inmunoprofilaxis Rh
- versión cefálica externa
- embarazo molar
- embarazo ectópico
Diagnostic investigations
1st investigations to order
- grupo sanguíneo materno
- cribado de anticuerpos Rh séricos maternos
Investigations to consider
- título de anticuerpos séricos maternos
- grupo sanguíneo paterno
- cigosis paterna
- ultrasonido fetal
- Velocimetría Doppler de la arteria cerebral media fetal (velocidad sistólica pico)
- determinación del grupo sanguíneo fetal (por amniocentesis o circulación maternal)
- evaluación directa de la anemia fetal
- prueba de rosetas
- prueba de Kleihauer-Betke/citometría de flujo
Treatment algorithm
madre RhD negativa no sensibilizada
madre RhD negativa sensibilizada
neonato con eritroblastosis
Contributors
Authors
Andrew D. Hull, MD, FRCOG, FACOG
Professor of Clinical Obstetrics, Gynecology, and Reproductive Sciences
Director, UC San Diego Maternal-Fetal Care and Genetics
Division of Maternal-Fetal Medicine
Department of Obstetrics, Gynecology, and Reproductive Sciences
University of California San Diego
La Jolla
CA
Disclosures
ADH declares that he has no competing interests.
Acknowledgements
Dr Andrew D. Hull would like to gratefully acknowledge Dr Karen Fung-Kee-Fung and Dr Felipe Moretti, previous contributors to this topic.
Disclosures
KFKF is an author of a reference cited in this topic. KFKF and FM declare that they have no competing interests.
Peer reviewers
Alan Cameron, MD
Honorary Professor of Medicine
University of Glasgow
Glasgow
UK
利益声明
AC is an author of several references cited in this topic.
Liakat Ali Parapia, MD, FRCP
Consultant Hematologist
Bradford Teaching Hospitals NHS Trust
Yorkshire Clinic
Bingley
Bradford
UK
利益声明
LAP declares that he has no competing interests.
Kenneth J. Moise, Jr., MD
Professor of Obstetrics and Gynecology
Texas Children's Fetal Center
Baylor College of Medicine/Texas Children's Hospital
Houston
TX
利益声明
KJM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Brennand J, Cameron A. Fetal anaemia: diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2008 Feb;22(1):15-29. 摘要
American College of Obstetrics and Gynecology. ACOG practice bulletin no. 181: prevention of Rh D alloimmunization. Obstet Gynecol. 2017 Aug;130(2):e57-70. 摘要
American Congress of Obstetrics and Gynecology. ACOG practice bulletin no. 192: management of alloimmunization during pregnancy. Obstet Gynecol. 2018 Mar;131(3):e82-90. 摘要
Qureshi H, Massey E, Kirwan D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn. Transfus Med. 2014 Feb;24(1):8-20.全文 摘要
Visser GHA, Thommesen T, Di Renzo GC, et al. FIGO/ICM guidelines for preventing Rhesus disease: a call to action. Int J Gynaecol Obstet. 2021 Feb;152(2):144-7.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Hidropesía fetal no inmune
- Infección por parvovirus
- Enfermedad hemolítica no RhD
更多 鉴别诊断指南
- ACOG clinical practice update: paternal and fetal genotyping in the management of alloimmunization in pregnancy
- ACOG clinical practice update: Rh D immune globulin administration after abortion of pregnancy loss at less than 12 weeks of gestation
更多 指南
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明