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本病诊断:妊娠合并自身免疫性溶血性贫血。诊断依据:①两次妊娠发生同一并发病,且均在孕3个月后,由于突然大量红细胞破坏,而产生剧烈头痛并逐渐加重。②输血治疗无效,这是由于Rh 抗体持续不断的输入母体,母体红细胞屡遭破坏所致。③Coombs 试验阳性,说明有溶血存在。④网织红细胞增多,骨髓象显示红系增生,细胞形态正常。⑤若能检验血、尿中的胆红素等成分,将更能提供有力依据.鉴别诊断:①缺铁性贫血:Hb 低,但红细胞数不低,经补铁或输血有效,血清铁低于正常值,<8.95μm(50μg/dl)。②巨幼红细胞性贫血:骨髓象显示有典型
Diagnosis of the disease: pregnancy complicated with autoimmune hemolytic anemia. Diagnosis is based on: ① the same pregnancy and pregnancy occurred twice, and 3 months after pregnancy, due to a sudden a large number of red blood cell damage, and produce severe headache and gradually increased. ② blood transfusions ineffective, which is due to continuous input of Rh antibody maternal repeated damage to the mother’s red blood cells. ③ chamber test positive, indicating the presence of hemolysis. ④ reticulocyte increased, bone marrow showed erythroid hyperplasia, normal cell morphology. ⑤ If you can test the blood, urine bilirubin and other ingredients, will be able to provide a strong basis for differential diagnosis: ① iron-deficiency anemia: Hb low, but the number of red blood cells is not low, iron or blood transfusion by effective iron low serum At normal values, <8.95 μm (50 μg / dl). Megaloblastic anemia: bone marrow showed a typical