Anti-D and sensitising events

Question 1

When is rhesus status checked for a pregnant mum?

Answer 1

Booking visit

Question 2

What are sensitising events?

Answer 2

Events causing foetal (Rh +ve) blood cells from crossing placenta into maternal (Rh -ve) circulation, causing anti-D IgG antibodies to form

These antibodies may result in the next baby having resus disease

Question 3

Give 4 examples of sensitising events. What must be done after they occur?

Answer 3

Delivery
Miscarriage
Antepartum haemorrhage
- Placental abruption
- Placenta praevia
Vasa Praevia
Invasive procedures i.e CVS, amniocentesis
External cephalic version
Trauma
Termination
Intrauterine Death
Ectopic pregnancy

Given anti-D within 72 hours of event

Question 4

Give 3 reasons for administration of anti-D immunoglobulin and what is the dose?

Answer 4

500IU

1. Routinely at 28 weeks and 34 weeks for all women Rh -ve (1500IU if single dose regimen)
2. After any sensitising event for all women Rh -ve
3. After delivery if baby is Rh +ve for all women Rh -ve

Question 5

A large feto-maternal haemorrhage has occured. What test should be done and why?

Answer 5

Kleihauer test –> determine dosage of anti-D immunoglobulin to give

Question 6

What is a fatal complication of resus disease?

Answer 6

Hydrops fetalis