Rh阴性血型50例孕妇妊娠结局分析

Analysis of pregnant outcomes of 50 cases with Rh negative blood type

目的 探讨Rh阴性血型孕妇妊娠结局及相应并发症处理、预防措施。方法 选择50例孕妇入院后经血型抗体检测显示为RH阴性为研究组，随机抽取同期住院健康孕妇50例定为对照组，分析两组孕妇妊娠结局。结果 两组孕妇产后出血、羊水污染Ⅲ度、新生儿窒息、低体重儿、转NICU、胎儿死亡发生率比较无显著性差异（χ^2分别为0．00、0．00、0．00、0．00、1．60、1．01，均P＞0．05），且两组产后出血量比较无显著性差异（t＝0．11，P＞0．05）。而研究组剖宫产率、早产率及新生儿高胆红素血症发生率明显高于对照组（χ^2分别为4．03、10．70、8．27，均P＜0．05）。ABO血型不合中Rh抗体阳性发生率显著高于阴性发生率（χ^2=4．05，P＜0．05）。14例母儿ABO血型不合患者中，11例（78．57％）发生新生儿溶血，死亡2例，其余均存活。结论 Rh阴性血型孕妇对孕妇本身影响不大，易引发新生儿溶血。对Rh阴性妇女加强孕期监护，孕期给予合理治疗，必要时给予血浆置换、宫内输血等综合治疗，均可降低新生儿及围产儿不良事件发生率。

Objective To explore the pregnancy outcomes of Rh negative pregnant women and the complication treatment and prevention measures.Methods Totally 50 pregnant women with Rh negative blood type after blood antibody test in hospital were selected in study group, and another 50 healthy pregnant women hospitalized at the same period were randomly selected in control group .Pregnant outcomes of two groups were analyzed .Results There were no significant differences in the rates of postpartum hemorrhage , amniotic fluid pollutionⅢdegree, neonatal asphyxia, low weight, transferring to NICU and fetal death between two groups （χ^2value was 0.00, 0.00, 0.00, 0.00, 1.60 and 1.01, respectively, all P〉0.05）, and the amount of postpartum bleeding volume was not significantly different between two groups （t=0.11,P〉0.05）.But the rates of cesarean section , preterm birth and neonatal hyperbilirubinemia in the study group were significantly higher than those in the control group （χ^2value was 4.03, 10.70 and 8.27, respectively, all P〈0.05）.Rh antibody positive rate was significantly higher than negative rate in ABO blood type （χ^2=4.05,P〈0.05）.Among 14 cases of maternal and fetal ABO blood group incompatibility, 11 cases suffered neonatal hemolysis （78.57%） and 2 died.The rest were survival.Conclusion Rh negative blood type has mild influence on pregnant women themselves , but it will easily lead to hemolysis .Some measures such as strengthening pregnancy care, giving proper treatment at pregnant period , providing comprehensive treatment including plasmapheresis and intrauterine transfusion if necessary for Rh negative women can reduce the incidence of neonatal and perinatal adverse events .