在加拿大进行产前,产后和新生儿免疫血液学测试的指南:经过修改的Delphi过程的共识建议
Lani Lieberman1, Catharine M Walsh2, Rebecca Barty3
1Laboratory Medicine Program, University Health Network, Toronto, Ontario, Canada; Precision Diagnostics and Therapeutics Program, Sunnybrook Health Sciences Centre, Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada.
概括
加拿大专家制定了关于产前,产后和新生儿免疫血液学测试以及用于预防胎儿和新生儿血液溶解性疾病 (HDFN) 的Rh(D) 免疫球蛋白的共识指南. 这份指南旨在规范护理,改善高发性肺炎的诊断和预防.
科学领域:
- 产科和妇科
- 新生儿医学
- 免疫血液学
背景情况:
- 在产前,产后和新生儿免疫血液学测试和Rh(D) 免疫球蛋白 (RhIG) 管理方面缺乏标准化.
- 各中心测试方案的差异阻碍了胎儿和新生儿血液溶解性疾病 (HDFN) 的最佳预防.
研究的目的:
- 建立加拿大关于免疫血液学测试和RhIG管理的共识指南.
- 通过标准化实践降低HDFN的风险并改善诊断.
主要方法:
- 一个涉及国家多学科专家小组的德尔菲方法.
- 使用5点的利克特度量表进行代投票,直到达成共识 (克朗巴赫α>0.95).
- 包括评审小组评价≥4/5的陈述.
主要成果:
- 四十六名专家参与了调查,在三轮调查中获得了100%的响应率 (Cronbach的alpha=0.94).
- 在49个提议中的44个达成共识.
- 该指南包括产前检测 (21项声明),胎儿 - 母亲出血 (FMH) 检测和 RhIG 管理 (15项声明),以及新生儿监测 (8项声明).
结论:
- 开发的加拿大共识指南优化了对高危孕妇的监测.
- 建议旨在规范RhIG的使用时间和剂量.
- 该指南支持安全,及时和经济有效的预防和管理HFN.
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