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目的对1例ABO正反定型不合发现IgM+IgG抗-E所致新生儿溶血病(HDN)产前漏诊的病例分析。方法分别用盐水法、LISS-IAT等方法检测母亲血浆、患儿血浆、患儿红细胞放散液中同种抗体特异性并测其效价。结果患儿血浆、患儿红细胞放散液中均检出IgG抗-E、母亲血浆中检出IgM+IgG抗-E,孕妇于38+5周行剖宫术,产后因患儿黄疸出现较早且胆红素值升高速度较快遂给予丙球输注及蓝光照射治疗。结论围产期应做好HDN产前预测,对于不规则抗体阳性的母亲应密切监测血清抗体水平变化及抗体分型鉴定对于高危患者及时采取有效措施干预,减少患儿受累。
Objective To analyze the prenatal diagnosis of misdiagnosis of neonatal hemolytic disease (HDN) caused by IgM + IgG anti-E in one case of ABO positive and negative stereotypes. Methods The specificity of alloantibodies in erythrocyte effusion of mother’s plasma, children’s plasma and children was detected by saline method and LISS-IAT respectively. Results In children with plasma, erythrocyte discharge in children were detected IgG anti-E, IgM + IgG anti-E was detected in the mother’s plasma, pregnant women in 38 +5 weeks cesarean section, postpartum due to children with jaundice earlier And bilirubin value increased faster then give c balloon infusion and blue light irradiation treatment. Conclusions The perinatal period should be done prenatal HDN prenatal diagnosis. For irregular antibody positive mothers, the level of serum antibody should be closely monitored and the antibody typing identification should be taken timely and effectively to reduce the involvement of children.