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母子血型不合新生儿溶血病是同种被动免疫性疾病。目前对反复死胎、新生儿全身水肿流产、早产的重症 Rh 溶血病缺少有效的办法。我们发现1例重症RhE 液血病孕妇,曾有死胎史、输血史致使本次妊娠抗体效价增高。为避免再次死胎、早产,我们采用孕期血浆置换法进行治疗,孕妇顺利分娩,胎儿存活。患者24岁,曾于1985年9月足月妊娠死胎分娩,输 O 型血400ml。本次妊娠26周经血型血清学实验,发现夫妇 RhE 血型不合,孕妇血清中查出免疫性抗 E 抗体,效价为256~+,确诊为 RhE 溶血病。孕28周开始采用血浆置换治疗,每周1次共换出孕妇血浆3600ml,换入正常人血浆2200ml,抗体效价由256~+降至128。孕36周时在严密监护下提前分娩一男婴,体重3600g。
Maternal and neonatal blood group hemolytic disease is the same kind of passive immune disease. Currently on repeated stillbirth, neonatal systemic edema abortion, premature delivery of severe Rh hemolytic disease is not an effective way. We found that 1 case of severe pregnant women with RhE myxoid disease, had a history of stillbirth, blood transfusion history led to increased antibody titer of pregnancy. In order to avoid stillbirth again, premature delivery, we use plasmapheresis during pregnancy for treatment, pregnant women, smooth delivery, fetal survival. The patient, 24 years old, had a stillbirth of full-term pregnancy in September 1985 and delivered 400 ml of O-type blood. The 26-week pregnancy serum serological test found that the couple RhE blood group incompatibility, pregnant women detected in serum anti-E antibody, titer of 256 ~ +, diagnosed as RhE hemolytic disease. 28 weeks pregnant began to use plasma exchange therapy, once a week for a total exchange of pregnant women, 3600ml plasma, into normal human plasma 2200ml, antibody titer down to 128 from 256 ~ +. At 36 weeks of gestation, a baby boy was delivered ahead of time under strict surveillance, weighing 3600 g.