小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
危险因素
- 母体 RhD 阴性状态
- 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
诊断性检查
首要检查
- 孕妇血型
- 孕妇血清 Rh 抗体筛查
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
治疗流程
RhD 阴性孕妇
幼红细胞增多症新生儿
撰稿人
作者
Karen Fung-Kee-Fung, MD, FRCSC, MHPE
Associate Professor
Department of OB/GYN
Division of Maternal-Fetal Medicine
The Ottawa Hospital
University of Ottawa
Ottawa
Canada
利益声明
KFKF is an author of a reference cited in this topic. KFKF declares that she has no competing interests.
Felipe Moretti, MD
Program Director
Maternal-Fetal Medicine Fellowship
Associate Professor
Department of OB/GYN
Division of Maternal-Fetal Medicine
The Ottawa Hospital
University of Ottawa
Ottawa
Canada
利益声明
FM declares that he has 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 monograph.
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.
鉴别诊断
- 非免疫性胎儿积液
- 细小病毒感染
- 非 RhD 溶血性疾病
更多 鉴别诊断指南
- ACOG 实践指南第 192 条：妊娠期间同种免疫的处理
- ACOG 实践指南第 181 条：Rh D 同种免疫的预防
更多 指南
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