在 RhD 阴性妇女进行第一季度堕胎时进行 rhesus 检测和抗D 预防-系统性审查和意见
Kristina Gemzell-Danielsson1,2, Sharon Cameron3, Teresa Bombas4
1Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
概括
最近的指导方针建议在第一季度堕胎的RhD阴性妇女不使用免疫球蛋白G (IgG) 抗D预防. 本综述分析了证据,以支持有关 RhD 检测和预防的知情临床决策.
科学领域:
- 产科和妇科 产科和妇科
- 免疫学 免疫学 免疫学
- 围产儿医学 围产儿医学
背景情况:
- 免疫球蛋白G (IgG) 抗D预防显著降低了RhD与胎儿和新生儿的免疫和溶血性疾病.
- 在第一季度堕胎中,常规抗D预防的证据有限.
- 目前的做法各不相同,需要对指导方针和文献进行审查.
研究的目的:
- 分析国际和国家基于证据的关于Rh测试和抗D预防的指导方针.
- 审查支持或反对这种做法的文献.
- 为了促进知情的临床决策.
主要方法:
- 从2003年到2024年,对多个数据库 (PubMed,EMBASE,Cochrane,Google Scholar) 的系统文献搜索.
- 包括指南,评论,元分析,观察性研究,RCT,现实数据和队列研究.
- 由两位作者进行的独立选和数据提取.
主要成果:
- 最近的指导方针 (例如,世卫组织,2022年以后) 建议在第一季度堕胎时不使用抗D.
- 较旧的指导方针经常建议在12周之前进行RhD测试和抗D预防,怀孕年龄值各不相同.
- 差异源于不同的证据解释,可用性和社会法律因素.
结论:
- 需要基于证据的,协调的指导方针,关于IgG抗D在第一季度堕胎的预防.
- 医疗保健提供者必须随时了解最新的建议.
- 与患者共享决策对于管理经历RhD阴性妇女的第一季度堕胎至关重要.
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