ch. 36: hemolytic disorders Flashcards
What is Rh incompatibility/ isoimmunization?
when an Rh- mom has a Rh+ fetus
What is the result of a Rh- mom and Rh+ dad w/ homozygous Rh factor?
all offsprings will be Rh+
What is maternal sensitization?
Rh negative mom produces antibodies when blood meets Rh+ fetus blood
What events can lead to maternal sensitization?
1) pregnancy
2) birth
3) miscarriage or induced abortion or ectopic pregnancy
4) amniocentesis or chorionic villus sampling
5) external cephalic version
6) trauma
7) transfusion w/ Rh+ blood
8) placental abruption
How often is intrauterine transfusion performed?
as often as every 2 weeks
Until what gest age is intrauterine transfusion performed?
until fetus reaches pulmonary maturity at ~ 37-38 weeks
How does RhoGAM work?
injection of anti-Rh antibodies destroys fetal RBCs in moms circulation and BLOCKS maternal antibody production
When should RhoGAM be asministered?
-to Rh- mom at 28 weeks gest
-within 72 hrs after delivery
-after an invasive procedure and any time there is a risk of fetal-maternal hemorrhage
What is ABO incompatibility?
-when fetus blood type is A, B, or AB
-and moms blood type is O (has anti-A and anti-B antibodies)
Can first borns be affected by ABO incompatibility?
yes bc mom already has anti-A and anti-B antibodies in blood
What is the most common result of ABO incompatibility?
hyperbilirubinemia
What procedure is done to detect fetal anemia intrauterine?
MCA-PSV
What the indication for intrauterine transfusion?
if MCA-PSV shows hct <30%
How is the infants blood type and Rh stauts determined at birth?
cord blood is sent to lab testing
-Coombs test is done to determine if it contains maternal antibodies
What may be needed if there is severe hyperbilirubinemia?
exchange transfusion
What language is crucial when communicating with parents who have experienced a loss?
simple, unambiguous, and consistent language
What is appropriate to say to bereaved parents?
“im sad for you”
“how are y doing with all of this?”
“This must be hard for you”
“What can I do for you?”
“I’m sorry”
“im here, and I want to listen”
What is NOT appropriate to say to bereaved parents?
“God has a purpose for her”
“Be thankful you have another child”
“the living must go on”
“i know how you feel”
“youre young, you can have another one”
“this happened for the best”
“Better for this to happen now, before you knew the baby”
“there was something wrong with the baby anyway”
