誘導妊娠中絶と Rh 敏感症の危険

Sarah Horvath¹, Zhen-Yu Huang², Nathanael C Koelper³

¹Department of Obstetrics and Gynecology, Penn State University College of Medicine, Hershey, Pennsylvania.

JAMA

|September 26, 2023

まとめ

誘導性妊娠中絶はRh感受性のリスクを伴わない. Rh検査とRh免疫グロブリン治療は,通常,妊娠12週間前には不要であり,ケアを簡素化します.

科学分野:

産婦人科
免疫学
生殖健康

背景:

集団データは,Rh免疫グロブリンが妊娠12週間前には不要であることを示唆しているが,臨床的証拠は限られている.
異なるガイドラインは,Rh検査と治療のリスク/利益に関して混乱を引き起こします.
妊娠中絶の頻度が増加しているため血液型検査の明確性が求められています

研究の目的:

胎児赤血球 (fRBC) への母親の曝露の頻度を決定するために,誘導妊娠中絶後のRh感受性の値を超えています.
早期妊娠中絶におけるRh検査とRh免疫グロブリン投与の必要性を評価する.

主な方法:

多中心型,観察型,前向きなコホート研究が行われました.
高通量フローサイトメトリーは,506人の被験者の妊娠中絶 (薬剤または手術) の前後にペアリングされた母親の血液サンプルを分析した.
主なアウトカムとして測定されたのは,fRBC数値が感受性の値を超えた参加者の割合 (125 fRBC/ 500万 RBC) であった.

主要な成果:

妊娠中絶後の感受性の値を超えるfRBC数が増加したのは,参加者の0. 2%のみでした.
妊娠中絶後のFRBC数と,基値の関連性は見つかりませんでした.
基数からfRBC数の中央値の変化はゼロで,増加は最小値であった.

結論:

妊娠中の妊娠中絶はRh感受性の危険因子ではありません
妊娠12週間前には,Rh検査とRh免疫グロブリン治療は不要である可能性があります.
早期妊娠中絶後のRh免疫グロブリン使用に関する国際ガイドラインを参考にすることができます.

さらに関連する動画

07:13

Induction of Maternal Immune Activation in Mice at Mid-gestation Stage with Viral Mimic PolyI:C

Published on: March 25, 2016

18.5K

08:19

Isolation of Leukocytes from the Human Maternal-fetal Interface

Published on: May 21, 2015

16.1K

関連する概念動画

01:19

Rh Blood Group

1.5K

The Rhesus (Rh) antigen is crucial in determining blood groups and ensuring compatibility during blood transfusions.

1.5K

01:07

Teratogenicity

2.5K

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...

2.5K

01:22

Development of Immunocompetence

339

The initiation of cell-mediated immunity can be observed as early as the third month of fetal growth, with active antibody-mediated immunity following approximately one month later.
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...

339

02:45

Blood Transfusion and Agglutination

10.9K

Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...

10.9K

01:10

Blood Typing

1.2K

Understanding an individual's blood group is a critical component of transfusion medicine. It ensures compatibility in blood transfusions, organ transplants, and even during pregnancy. Determining these blood groups involves the ABO and Rh blood typing systems, utilizing specific antigens and corresponding anti-sera to identify an individual's blood type.
Antigens are protein molecules that reside on the surface of red blood cells (RBCs). The ABO and Rh blood typing systems target...

1.2K

関連する実験動画

誘導 妊娠 中絶 と Rh 敏感 症 の 危険