RH阴性孕妇妊娠二胎的临床分析

Clinical Analysis of Second Pregnancy in RH Negative Pregnant Women

目的分析RH阴性孕妇妊娠二胎的妊娠结局及产后情况。方法选取2014年1月至2018年12月在本院分娩的Rh阴性孕妇23例,设为Rh阴性组,另选同期在本院分娩的Rh阳性孕妇23例,设为Rh阳性组,两组均检测接受孕前超声检查,并跟踪妊娠结局,分析两组孕妇妊娠结局、新生儿情况以及Rh组内信息。结果 Rh阴性组年龄、孕次、产次、孕周、初产妇、经产妇与Rh阳性组间比较,数据无显著性差异(P> 0.05);Rh阴性组产后出血率、羊水污染Ⅲ度率、低体质量出生儿、转NICU新生儿率、新生儿窘迫率、死胎率与Rh阳性组间数据比较,无显著性差异(P> 0.05);Rh阴性组剖宫产率、早产率、高胆红素新生儿率与Rh阳性组间数据比较,存在显著性差异(P <0.05);Rh阴性组母婴ABO血型相合者16例(包括Rh抗体阳性6例,Rh抗体阴性10例),母婴ABO血型不合7例(包括Rh抗体阳性1例,Rh抗体阴性6例);母婴ABO血型不合7例,发生新生儿溶血者5例,死亡1例,存活6例。结论 RH阴性孕妇妊娠二胎妊娠结局风险高于RH阳性孕妇,建议加强孕前管理,分娩前做好备血工作,并在出现新生儿溶血、产后出血等情况时积极治疗,从而提高产妇及围生儿的安全性。

Objective To analyze the pregnancy outcome and postpartum status of the second fetus of RH negative pregnant women. Methods 23 Rh-negative pregnant women delivered in our hospital from January 2014 to December 2018 were selected as Rh-negative group and 23 Rh-positive pregnant women delivered in our hospital during the same period were selected as Rh-positive group. Prenatal ultrasound examination was performed in both groups, and pregnancy outcomes were tracked. Pregnant outcomes, neonatal status and Rh in both groups were analyzed. Intra-group information. Results There was no significant difference between Rh-negative group and Rh-positive group in age, number of pregnancies, parity, gestational weeks, primipara and multipartum women(P>0.05);postpartum hemorrhage rate, amniotic fluid pollution Ⅲ rate, low birth weight, NICU rate, neonatal distress rate, stillbirth rate and Rh-yang rate in Rh-negative group. There was no significant difference between the two groups(P>0.05). There were significant differences in the cesarean section rate, premature delivery rate and high bilirubin neonatal rate between the Rh negative group and the Rh positive group(P<0.05). In the Rh negative group, 16 cases(including 6 Rh positive cases and 10 Rh negative cases), 7 cases(including 1 Rh positive case and 6 Rh negative cases), 7 cases(including 1 Rh positive case and 6 Rh negative cases), 5 cases of ABO blood group incompatibility, 5 cases of neonatal hemolysis, 1 case of death and 6 cases of survival) were found. Conclusion The risk of second pregnancy outcome of RH negative pregnant women is higher than that of RH positive pregnant women. It is suggested that prenatal management should be strengthened, blood preparation should be done well before delivery, and active treatment should be taken when neonatal hemolysis and postpartum hemorrhage occur, so as to improve the safety of pregnant women and perinatal infants.