Rh tsis sib xws

Rh kev tsis sib xws yog ib qho mob uas muaj kev txhim kho thaum tus poj niam cev xeeb tub muaj ntshav Rh-tsis zoo thiab tus menyuam hauv nws lub tsev menyuam muaj Rh-positive ntshav.

Thaum cev xeeb tub, ntshav liab los ntawm tus menyuam tseem nyob hauv plab yuav nkag mus rau hauv leej niam cov ntshav los ntawm tus menyuam txiaj.

Yog tias leej niam yog Rh-negative, nws lub cev tiv thaiv kab mob Rh-zoo tus me nyuam hauv plab zoo li txhais tau tias nws yog lwm yam khoom txawv teb chaws. Leej niam lub cev ua cov tshuaj tiv thaiv cov qe ntshav ntawm tus menyuam. Cov tshuaj tiv thaiv kab mob no tuaj yeem hla dhau los ntawm kev tso txiv neej mus rau hauv tus me nyuam kev loj hlob. Lawv muab tus menyuam cov ntshav liab ncig ua ntshav ua puas tsuaj.

Thaum cov qe ntshav liab tau tawg, lawv ua bilirubin. Qhov no ua rau tus menyuam mos liab daj (daj). Qib ntawm bilirubin hauv cov ntshav cov me nyuam muaj txij li me mus rau theem txaus ntshai.

Feem ntau cov menyuam mos thawj zaug feem ntau tsis raug cuam tshuam tshwj tsis yog leej niam tau ua txhaum yav dhau los lossis rho menyuam. Qhov no yuav mob nws lub nruab nrog cev. Qhov no vim tias nws siv sijhawm rau leej niam los tsim cov tshuaj tiv thaiv. Txhua tus me nyuam nws muaj tom qab uas kuj yog Rh-positive yuav raug cuam tshuam.

Rh kev tsis sib xws tsuas yog tshwm sim thaum tus niam yog Rh-tsis zoo thiab tus menyuam mos yog Rh-zoo. Qhov teeb meem no tau dhau los ua tsawg dua hauv cov chaw uas muab kev saib xyuas ua ntej zoo. Qhov no vim hais tias tshwj xeeb cov tshuaj tiv thaiv kab mob txhaws hu ua RhoGAM tau niaj hnub siv.

Rh kev tsis sib xws tuaj yeem ua rau cov tsos mob los ntawm mob sib khuav heev txog rau thaum tuag. Hauv nws daim ntawv me tshaj plaws, Rh txoj kev tsis sib xws ua rau kev puas tsuaj los ntawm cov ntshav liab. Tsis muaj lwm yam cuam tshuam.

Tom qab yug los, tus menyuam yuav muaj:

• Kev daj daj ntawm daim tawv thiab ntsiab muag ntawm lub qhov muag (daj)
• Cov leeg tsis tshua muaj leeg (hypotonia) thiab lub zog tsis muaj zog

Ua ntej yug menyuam, leej niam yuav muaj kua dej ntau dua nyob ib puag ncig nws tus menyuam hauv plab (polyhydramnios).

Tej zaum yuav muaj:

• Qhov ntsuas pom ntawm Coombs ncaj qha
• Cov qib siab dua li ib txwm muaj ntawm bilirubin hauv tus me nyuam txoj hlab ntaws ntshav
• Cov tsos mob ntawm cov ntshav liab kev puas tsuaj hauv tus menyuam mos cov ntshav

Rh kev tsis sib haum tuaj yeem tiv thaiv nrog kev siv RhoGAM. Yog li, kev tiv thaiv tseem yog qhov kev kho mob zoo tshaj plaws. Kev kho mob ntawm cov menyuam mos uas twb muaj kev cuam tshuam nyob ntawm qhov mob loj npaum li cas.

Cov menyuam mos liab uas muaj kev tsis sib haum Rh nrog kev kho mob siv duab ci ci nrog bilirubin teeb. Koob tshuaj tiv thaiv IV globulin tiv thaiv kab mob kuj tseem siv tau. Rau cov menyuam mos cuam tshuam loj heev, yuav tsum muaj ntshav pauv hloov. Qhov no yog kom txo tau cov theem ntawm bilirubin hauv cov ntshav.

Tag nrho rov qab yog qhov cia siab rau mob me me ntawm Rh.

Teeb meem yuav suav nrog:

• Lub hlwb raug mob vim theem siab ntawm bilirubin (kernicterus)
• Kev muaj kua hauv lub cev thiab o ua rau tus menyuam (hydrops fetalis)
• Cov teeb meem ntawm lub hlwb ua haujlwm, txav, hnov ​​lus, hais lus, thiab qaug dab peg

Hu koj tus kws kho mob yog tias koj xav lossis paub tias koj xeeb tub lawm thiab tseem tsis tau pom tus kws kho mob.

Rh kev tsis sib xws yog yuav luag tiv thaiv tau. Rh-niam cov niam tsis zoo yuav tsum tau ua raws li cov neeg muab kev pab kom zoo thaum cev xeeb tub.

Cov tshuaj tiv thaiv kab mob tshwj xeeb (globulins), hu ua RhoGAM, tam sim no siv los tiv thaiv RH kev tsis sib xws ntawm cov niam uas muaj Rh-tsis zoo.

Yog tias leej txiv ntawm tus me nyuam mos yog Rh-zoo los yog tias nws cov ntshav tsis paub, tus niam yuav muab RhoGAM rau lub sijhawm thib ob lub hlis. Yog tias tus me nyuam yog Rh-positive, leej niam yuav tau txhaj koob tshuaj thib ob hauv ob peb hnub tom qab yug menyuam.

Cov koob tshuaj tiv thaiv no tiv thaiv kev txhim kho ntawm cov tshuaj tiv thaiv tawm tsam Rh-positive ntshav. Txawm li cas los xij, cov poj niam uas muaj hom ntshav Rh-negative yuav tsum tau txhaj tshuaj:

• Txhua lub sijhawm muaj menyuam hauv plab
• Tom qab nchuav menyuam lossis rho menyuam
• Tom qab kev kuaj mob ua ntej xws li amniocentesis thiab chorionic villus biopsy
• Tom qab raug mob rau lub plab hauv plab thaum cev xeeb tub

Rh-induced tus kab mob hemolytic ntawm tus me nyuam mos; Erythroblastosis fetalis

• Tus me nyuam mos liab daj - tso zis

• Erythroblastosis fetalis - photomicrograph
• Jaundiced tus me nyuam mos
• Tshuaj tua kabmob
• Hloov pauv ntshav - series
• Rh incompatibility - series

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Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Ntshav tsis txaus. Hauv: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Phau Ntawv ntawm PediatricsCov. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 124.

Moise KJ. Liab cell alloimmunization. Hauv: Gabbe SG, Niebyl JR, Simpson JL, li al, eds. Obstetrics: Li Qub thiab Teeb Meem NtxigCov. 7 tus ed. Philadelphia, PA: Elsevier; 2017: cha 34.