对预防恒河alloimmunisation Anti-D政府在怀孕。

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Crowther CA, Keirse乔丹

对预防恒河alloimmunisation Anti-D政府在怀孕。

科克伦数据库系统启2000;(2):CD000020。

PubMed ID

10796088 (在PubMed

]

文摘

背景:一个女人可能出现阴性抗体在她第一次怀孕时她的胎儿是rh阳性。孕28周后抗体发展最频繁。目的:本文的目的是评估的影响给产前anti-D免疫球蛋白在怀孕28周以上的发病率RhD alloimmunisation当给恒河-母亲没有anti-D抗体。必威国际app搜索策略:我们搜查了Cochrane妊娠和分娩组试验注册,科克伦对照试验注册,和参考书目。最后搜索日期:1998年1必威国际app2月。选择标准:随机试验在恒河抗体阴性的妇女没有anti-D anti-D怀孕28周后,相比之下,没有治疗或安慰剂。数据收集和分析:一位评论家和双输入提取的数据。主要结果:两个合格的试验,其中包括超过4500女性,而没有anti-D预防与治疗。尽管数据显示,当女性收到anti-D 28妊娠34周,孕期免疫的发生率降低(0 r O.44, 95%可信区间0.18 - -1.12),婴儿出生后恒河积极(或0.44,95%可信区间0.18 - -1.12),和恒河积极的婴儿出生后12个月内(或0.44,95%可信区间0.19 - -1.01),这些差异有统计学意义。试验中,使用了大剂量的anti-D (100 ug; 500IU), there was a clear reduction in the incidence of immunisation at 2-12 months following birth in women who had received Anti-D at 28 and 34 weeks (OR 0.22 95% CI 0.05-0.88). No data were available for the risk of RhD alloimmunisation in a subsequent pregnancy. No differences were observed in the incidence of neonatal jaundice. REVIEWER'S CONCLUSIONS: The risk of RhD alloimmunisation during or immediately after a first pregnancy is about 1.5%. Administration of 100ug (500IU) anti-D at 28 weeks and 34 weeks gestation to women in their first pregnancy can reduce this risk to about 0.2% without, to date, any adverse effects. Although such a policy is unlikely to confer benefit or improve outcome in the present pregnancy, fewer women will have Rhesus D antibodies in their next pregnancy. Adoption of such a policy will need to consider the costs of prophylaxis against the costs of care for women who become sensitised and their affected infants, and local adequacy of supply of anti-D gammaglobulin.

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药物

人类免疫球蛋白ρ(D)