产前预测胎儿血型方法的研究

Study on the Determination of Fetal Blood Group in Early Pregnancy

目的 :孕早期预测胎儿血型 ,对防治新生儿溶血病有着重要的意义。方法 :采用多种取材方法预测胎儿血型对比研究 :①绒毛活检共 5 5例 ,其中经腹取孕早期绒毛 10例。②经腹脐静脉穿刺取脐血 30例。③经腹取羊水共 72例 ,其中取孕早期羊水 2 0例。分别测羊水、绒毛血型物质和脐血血型。结果 :羊水、缄毛、脐血取材成功率分别为10 0 %、98.2 %、88.2 %。各种取材均可检测胎儿血型 (羊水非分泌型除外 ) ,与父母血型及产后脐血血型对照符合率10 0 %。结论 :三种取材方法各有其优点与适应症 :①经腹绒毛活检避免了经宫颈取标本的污染及母儿并发症。②孕早期羊水穿刺比中孕提前 4周 ,且成功率高。③取脐血直接测血型更准确、简便。因此这三种预测胎儿血型的取材方法是先进、科学、安全、可靠的 ,具有临床实用价值。

Objective:To determine fetal blood group in early pregnancy and predict fetal hemolysis disease.Methods:Different sampling methods were performed to determine fetal blood group ,i.e.55 cases by chorionic villus sampling,10 cases of them were taken transabdominally in early pregncy;30 cases by collecting cord blood transabdominal cordocentensis;72 cases by collecting amniotic fliud tranabdominal amniocentesis,20 cases of them were sample in early pregnancy.The blood group of amniotic fluid,chorionic villus,and cord blood determined differentially by the routine laboratory methods.Results:The success rate of sampling through amniotic fluid,chorionic villus,and cord blood were 100%,98.2%,88.2% respectirely.All of these specimen can be used for detecting fetal blood type(apart from nonsecretory amniotic fluid),and the results are consistant with maternal blood group and postnatal cord blood type.Conclusion :The study results showed that each sampling method has its own advantage and indications:①Transabdominal chorionic sampling avoided contamination and maternal complication caused by transcervical method.②Early pregnancy amniocentensis has higher success rate and the date of determination was advanced 4 weeks before midtimester.③Direct blood grouping using transabdominal cordocentensis is more accurate.We conclude that the 3 methods used to determine fetal blood type are safe,reliable and have clinical application value.