Anti-D Prophylaxis BCSH Flashcards
Risk alloimmunisation of RH-ve women after 2 x Rh+ve babies
i) No Anti-D prophylaxis
ii) Postpartum prophylaxis
iii) AN and PP prophylaxsis
i) 16%
ii) 2%
iii) 0.2%
When should anti-d be given after a sensitising event?
With 72 hrs, but can be given up to 10 days
What are considered sensitising events?
Invasive testing
APH
ECV
Abdo trauma
Ectopic preg
evacuation molar
IUD/stillbrith
In-utero intervetions
Therapeutic TOP
Delivery
Intra-op cell salvage
<20 weeks what dose minimum dose Anti D given? If FMH testing requireed
250
FMH not required
FMH over what volume requires further Anti-D
> 4ml
If >4ml how much additional dose is required?
125IU
If further IV or IM Anti-D is given, when should the FMH be retested?
IV - in 48hrs
IM - in 72 hours
If ongoing bleeding throughout pregnancy, how often should anti-D be given?
Minimum 500 every 6 weeks
FMH every 2 weeks
When should prophylactic anti-D be given and what dose
At 28 weeks, important 28 weeks blood taken first.
1500IU
Or can give 2 dose regime at 28 and 34 weeks
Following the delivery of baby to Rhesus -ve mother, what test should be done?
Cord blood: ABO and RhD
Maternal blood: ABO and RhD typing and FMH, should be taken after 30-45 mins of birth but within 2 hours.
If no cord blood is taken how can the babies blood group be determined?
Heel prick test
In cases of IUD when should the anti-D be given?
72 hours of Dx
If intra-operative cell salvage used?
1500IU immediately after infusion and FMH should be taken 30-45 mins after re infusion
If Rhesus -ve mother given Rh +ve platelets?
Give 250IU Anti D, this covered 5 doses of platelets in 6 week period
If >15mls of Rhesus +ve RBCs given to Rhesus -ve women?
1500-2500IU
Perform flow cytometryu IV 48hrs, IM 72 hrs after
