3例不明原因贫血胎儿宫内输血治疗疗效分析 [中文引用][英文引用]

目的 探讨宫内输血在不明原因贫血胎儿中的应用价值。方法 我们对不明原因出现贫血的3例胎儿进行了对症的宫内输血治疗，监测胎儿大脑中动脉峰值流速（MCA-PSV）、胎儿血红蛋白浓度、红细胞比容等指标，评估宫内输血在不明原因贫血胎儿中的治疗效果。 结果 3例贫血胎儿经过治疗，贫血情况均得到改善，病例1和病例2均顺利妊娠至足月分娩，病例3在术后第3天孕妇突发急性的肝功能、肾功能、凝血功能等多器官异常，于孕33+周早产剖宫产1男婴，新生儿因早产并发症住院治疗1月后出院。3例贫血胎儿随访至出生后1～1.5岁，发育情况与同龄儿相符。 结论 对于不明原因的严重贫血胎儿，若孕妇及家属保留意愿强烈，可考虑行宫内输血对症处理。

Objective To discuss the value of intrauterine blood transfusion in fetuses with unexplained anemia. Methods We applied intrauterine blood transfusion on 3 fetuses with unexplained anemia and monitored the peak velocity of middle cerebral artery (MCA-PSV), fetal hemoglobin concentration, hematocrit and other indicators to evaluate the therapeutic effect. Results 3 cases were improved after the treatments. Case 1 and 2 delivered at term successfully, however, Case 3 suffered from multi-organ abnormalities on the third day after surgery so that the baby was born at 33+ weeks of gestation. The newborn was hospitalized for complications of preterm birth and was discharged after 1 month. Three anemia fetuses were followed up to 1 year or 1.5 year after birth ，whose development was normal. Conclusions For unexplained fetuses with severe anemia, if the parents have a strong willingness to keep, intrauterine blood transfusion should be considered.