1B

Question 1

Define Rh incompatibility

Answer 1

Occurs during pregnancy when mother is Rh -ve and baby is Rh +ve

Question 2

What is Rhesus factor

Answer 2

protein on RBC, if present: Rh +ve

Question 3

Presentation of Rh incompatibility

Answer 3

If not detected during pregnancy, child:
jaundice
Lethargy
Fluid flare up

Question 4

Examination of Rh incompatibility

Answer 4

Usually checked during pregnancy
If not: jaundice, excessive fluid build up and lethargic baby

Question 5

DDx of Rh incompatility

Answer 5

ABO incompatibility
Haemolytic anaemia

Question 6

Investigation for Rh incompatibility

Answer 6

Rh testing
Rh antibody testing: if Rh negative
Bilirubin for newborn: assess haemolysis

Amniocentesis- if father’s rhesus status can not be determined

Question 7

Management of Rh incompatibility

Answer 7

IM: Anti-D Ig to mum - attached to the baby’s RBC in mothers circulation- prevents recognition of foreign body
given at 28 weeks gestation and after birth

Blood/plasma transfusion: babies with haemolytic anaemia

Question 8

Complication of Rh incompatibility

Answer 8

Heart failure
Seizures
Anaemia
Fluid build-up/swelling

Question 9

How are Rh incompatibility associated with haemolytic anaemia

Answer 9

After the first pregnancy with incompatibility, mother makes Ab against Rh factor.
During the second pregnancy the antibodies are passed through the placenta and attack the baby’s RBCs