Anti-D Flashcards
1
Q
Timeframe to give anti D after sensitizing event
A
72h
2
Q
If <12 weeks, when to give anti-D
A
- Ectopic - all regardless of mx
- Molar preg
- Medical/surigcal TOP
- Heavy bleeding w abdo pain
- Miscarriage before 12w with no abdo pain- Anti D not needed
3
Q
Dose of anti D <12w and 12-20w
A
250units, KH not needed
4
Q
Sensitizing events >12w
A
- Amniocentesis
- APH
- ECV
- Abdo trauma
- IUD/SB
- Ectopic
- Molar preg
- Miscarriage
- MTOP
- Delivery
- Cell salvage
5
Q
Plan for repeated bleeding
A
- 250iu at time of the event
- Repeat doses every 6 weeks
- FMH test 2weeks after bleeding stops
6
Q
Dose of anti D based on FMH test
A
- 125iu IM/100IU IV per ml of fetal red cells detected
7
Q
Dose of anti D >20w
A
500u
KH test and repeat dose if needed
8
Q
Timing and dose for antenatal prophylaxsis
A
28 weeks - 1500iu
or
28 and 34w - 500iu x2
9
Q
G+S at 28 weeks
A
- Test before anti D
- If anti-D is present in G+S (from prev rx), perform further tests for origin ( immune or passive)
10
Q
F/u if Anti-D is present in blood but wo origin
A
- Monthly till 28 weeks
- every 2 weeks 28w-birth
11
Q
Sensitizing event after prophylaxsis
A
Give additional dose of anti-D
12
Q
PN anti-D
A
500u if SVD/CS
1500u if cell salvage used
Check for FMH
13
Q
Testing for FMH and cut off
A
Fetal sample-
- 30min - 2h after birth
- Use kleihauer not DAT on cord blood
Maternal-
- If FMH>4ml, repeat sample after anti D
- 48h if IV, 72h if IM antiD
14
Q
Platelets and anti D
A
- Women of reporductive age should get D NEG plts
- If D+ given (to Rh -) : 250iu anti D covers 5x plts doses in 6 weeks.
- If not child bearing age- no need for anti D for plts
