重新考虑在怀孕期间的例行重复组和屏幕 - - 个性化怀孕护理
Ann Tran1, Gwen Clarke2, Jeannie L Callum3
1Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC.
概括
在怀孕晚期的常规反体查可能不必重复. 一项审查发现,出现新的临床显著抗体 (CSA) 的风险非常低,这表明目前的指导方针可以对低风险怀孕进行修订.
科学领域:
- 产科和妇科 产科和妇科
- 输血医学 输血医学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 怀孕期间的抗体查对于识别临床显著抗体 (CSA) 至关重要.
- 目前的指导方针经常建议在妊娠28周,有时在分娩前重复抗体查.
- 在基于RhD状态和其他因素的指导方针中存在差异.
研究的目的:
- 评估在妊娠晚期进行常规反体查的必要性.
- 评估晚期的免疫接种的风险及其对胎儿健康的潜在影响.
主要方法:
- 审查现有关于怀孕后期新发现CSA发生率的数据.
- 分析与晚期合免疫接种相关的风险,导致严重的胎儿血液溶解或贫血.
主要成果:
- 在孕期晚期 (晚期合免疫) 检测出新的CSA的风险很低,范围为0.01%至0.43%.
- 由于晚期与免疫接种的严重胎儿血液溶解/贫血的风险甚至更低,不到0.01%.
结论:
- 在28周时进行常规反体查,并且分娩可能不对所有怀孕都至关重要.
- 研究结果表明,可能需要修订健康低风险怀孕指南,以减少不必要的测试.
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