Antenatal Care: Rhesus Isoimmunisation Flashcards
Define RBC isoimmunisation
Production of antibodies in response to isoantigens on erythrocytes
Explain pathophysiology of rhesus isoimmunisation
Rhesus negative mother, Rhesus positive partner - have rhesus positive foetus. If foetal blood enters maternal circulation (rhesus antigen) then mother will produce immune response and IgG antibodies against rhesus. If mother has another rhesus positive child, these pre-formed antibodies will cross the placenta and cause heamolysis.
What should be checked following a sensitising event
Maternal blood group, Rhesus status
Kleinbauer test
When is maternal blood group and rhesus isoantigens checked in routine antenatal care
12W and 28W
When is a kleinhauer test used and why
It is used after 20W to determine how much foetal blood entered maternal circulation
Post-delivery what should be checked
Rhesus status of the foetus
What is used to prevent rhesus isoimmunisation
Anti-D is given to rhesus negative women at 28 and 34W
What may cause a sensitising event
Anything that causes haemorrhage
- Antepartum haemorrhage
- Miscarriage
- TOP
What are 3 indications for anti-D prior to 12W
Uterine bleed
Molar pregnancy
Ectopic
What is checked in event prior to 12W
Maternal blood group and rhesus status
What is given if sensitising event before 12W
250IU anti-D in 72h of event
What is checked if sensitising event 12-20W
Maternal blood group and rhesus status
What is given if sensitising event 12-20W
250IU anti-D in 72h of event
What is checked if sensitising event after 20W
Maternal blood group
Kleihauer test
What is given if sensitising event after 20W
500IU anti-D in 72h
