Abo Flashcards
Is a destruction of the fetus and neonate by ab produced by the motter
Hdn and newborn
It is conditioned in which the life span of the fetal neonatal red cell is shortened due to
Maternal allo ab against red cell ag acquired from th father
Made from four polypeptide chain
Two light chain
Two identical heavy chain
Blood grouo ab can be classified as
Naturally occuring and immune ab
Cold and warm ab
Most immune abs are
Warm and can destroy red cell in vivo
Most natural abs are
Cold and wide thermal range like anti A and B
It is incomplete ab
Igg
Is a complete ab most naturally occuring ab
IgM
what are Ab of ABO system
Anti A, anti B, anti A1 and anti H
What are the Ab in ABO system that is naturally occurring and immune
Anti A and Anti B
Natural occurring in ab of rh system
Anti E
What is occassionally naturally occurring of Ab rh system
Anti D and anti C
This is mor immunogenic
D Ab
Most common in immune Abs is
anti E
After Anti D what is common cause of HDN
Anti c
Kell blood group system
Anti K
Kidd blood group system
Anti JKa
Are series of protein present in plasma as inactivate precursors
Complement
Complement activation involves and cause rapid destruction of red cell
Complemet
Complement activation involves 2 stages
Opsonization and lytic stage
Destruction depends on the amount of
Ab and complement
Coated rbc are removed by
Mononuclear phagocytic system
Less severe form
Mild anemia
Severe form
Icterus gravis neonatorum or kernicterus
Intrauterine death
Hydrops fetalis
Extravascular hemolysis of extramedullary erythropoiesis
Hepatic and cardiac failure
Oedematous ascites, bulky swollen and friable placenta
Pathophysiology
Hydrops fetalis
Hdn before birth
Anemia
Heart failure
Fetal death
Hdn after birth
Anemia Heart failure Build up of bilirubin Kernicterus Severe growth retardation Unconj bilirubin more than 18mgdl
Rh hdn ab against
Anti D less common anti c and anti E
Sensitization of mother occur
During gestation
At the time of birth
All subsequent offspring inheriting D Ag will be affected in case of
Anti D HDN
Factors affecting immunization and severity
Antigenic exposure
Host factors
Ab specificity
Influence pf abo group
Diagnosis cooperation bet
Pregnant women
Ob
Her spouse
Clin lab
Ab detection repeat testing required at
24 or 28 weeks first test neg
To detect clinically significant pf ab detection is
Igg ab which reacts at 37 deg
Recommended ob practice
Abo and rh testing History of prev pregnancy Ab detection Ab specificity Parental phenotype Amniocyte testing Ab titers
Ab titers difference of
2 dikution or score more than 10 is significant
Amniocentesis and cardiocentesis
Core of bilirubin
Spectrophotometric scan
Fetal blood sample can be tested
Increasing or unchange OD as pregnancy advance shows worsening of the fetal hem dse
Spectrophotometric scan indirect kethod
Fetal blood sample can be taken and tested for
Hb hct blood type and direct coombs test
Diagnosis and mgt
Intrauterine transfusion
Early delivery
Phototherapy
Newborn transfusion
Zone II or III
Intrauterine transfusion
Cardiocentesis blood sample hb less than 10g/dl
Ultrasound with evidence of hyrops
Intrauterine transfusion
New transfusion
Exchange transfusion
Effects of transfusion
Effects of transfusion
Removal of bilirubin
Removal of sensitized rbc and ab
Suppression of incompatible erythropoiesis
Selection of blood
Group O rbc
Rh neg units for rg neg case
Whole blood group O
Blood less than 7yoo
Prevention of active immunization
Administration of corresponding rbc ab which is Anti D
Use of high titer rh ig
Calculation of the dose
Kleuhauer test for fetal hb
What are predominant igm
Anti A and anti B
For practical purpose what group make high titer
Only group O individual make high titer IgG
Present ij the sera pf all individual whic rbc lack the corresponding Ag
Abo Ab
Two mechanism protect the fetus against
Anti A and anti B