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Rh 血型不相容

最后审阅: 1 Nov 2024
最后更新: 16 Feb 2023

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
完整详情

危险因素

  • RhD 阴性母体怀有 RhD 阳性胎儿的既往史
  • 胎母输血综合征
  • 胎儿有创操作
  • 胎盘创伤
  • 流产
  • 经产
  • Rh 免疫预防的疏漏
  • 胎头外倒转术
  • 葡萄胎妊娠
  • 异位妊娠
完整详情

诊断性检查

首要检查

  • 孕妇血型
  • 孕妇血清 Rh 抗体筛查
完整详情

需考虑的检查

  • 母体血清抗体滴度
  • 父亲血型
  • 父亲接合性
  • 胎儿超声检查
  • 多普勒测速仪测定胎儿大脑中动脉流速(收缩期峰值流速)
  • 胎儿血型检定(通过羊膜腔穿刺术或母体循环)
  • 胎儿贫血的直接评估
  • 玫瑰花环形成试验
  • Kleihauer-Betke 试验/流式细胞术
完整详情

治疗流程

初步治疗

未致敏的 RhD 阴性母体

已致敏的 RhD 阴性母体

急症处理

幼红细胞增多症新生儿

撰稿人

作者

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

利益声明

ADH declares that he has no competing interests.

鸣谢

Dr Andrew D. Hull would like to gratefully acknowledge Dr Karen Fung-Kee-Fung and Dr Felipe Moretti, previous contributors to this topic.

利益声明

KFKF is an author of a reference cited in this topic. KFKF and FM declare that they have no competing interests.

同行评议者

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.

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