Diagnosis and therapy of Rh(D) hemolytic diseases caused by maternal-fetal blood group incompatibility.

Objective: To explore using fluorescence quantitative PCR(FQ-PCR) for noninvasive prenatal diagnosis of fetal RhD blood type with free fetal DNA in RhD-negative maternal plasma and the effective of treating maternal-fetal Rh(D) incompatibility hemolysis disease with plasma exchange with comprehensive medications,prevent the spontaneous abortion and fatal death.Methods: The prenatal diagnosis of RHD genetyping was confirmed by FQ-PCR.The results of fetal RHD were confirmed with cord blood.We enrolled 29 women with maternal-fetal Rh(D) incompatibility hemolysis disease and divided them into two groups: Group A(n = 15) underwent plasma exchange combined with comprehensive medications;Group B(n = 14) was treated with comprehensive medicine alone.The titer of special anti-D IgG and Rh hemolytic disease of the newborn were detected in each group.Results: All cases were confirmed as accurate through serological measure of fetal umbilie blood after delivery.In group A,the titer of special anti-D IgG was 1∶(96±43.6) before plasma exchange,but it decreased to 1∶(18±14.7) after plasma exchange.There were significant difference between the titer of special anti-D IgG of pre-and post-treatment.It was from 1∶ 32 to 1∶ 256 during pregnancy in group B.There were 10 patients with maternal-fetal Rh(D) incompatibility hemolysis disease in group B,but it decreased to 4 patients in group A.The 10 cases of IgG anti-D,straight Coombs′test,liberation antibody were detected out in group B,but it decreased to 4 cases in group A.The serum bilirubin was(76.5±36)μmol/ L in group A and it was(154.6±46)μmol/ L in group B.Conclusion: FQ-PCR analysis for noninvasive prenatal of fetal RhD genotyping could be useful in prevention and diagnosis of hemolytic disease of newborn.The plasma exchange combined with comprehensive medications is safety,effective and recommendable in treating maternal-fetal Rh(D) incompatibility hemolysis disease.