ch. 36: hemolytic disorders

Question 1

What is Rh incompatibility/ isoimmunization?

Answer 1

when an Rh- mom has a Rh+ fetus

Question 2

What is the result of a Rh- mom and Rh+ dad w/ homozygous Rh factor?

Answer 2

all offsprings will be Rh+

Question 3

What is maternal sensitization?

Answer 3

Rh negative mom produces antibodies when blood meets Rh+ fetus blood

Question 4

What events can lead to maternal sensitization?

Answer 4

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

Question 5

How often is intrauterine transfusion performed?

Answer 5

as often as every 2 weeks

Question 6

Until what gest age is intrauterine transfusion performed?

Answer 6

until fetus reaches pulmonary maturity at ~ 37-38 weeks

Question 7

How does RhoGAM work?

Answer 7

injection of anti-Rh antibodies destroys fetal RBCs in moms circulation and BLOCKS maternal antibody production

Question 8

When should RhoGAM be asministered?

Answer 8

-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

Question 9

What is ABO incompatibility?

Answer 9

-when fetus blood type is A, B, or AB
-and moms blood type is O (has anti-A and anti-B antibodies)

Question 10

Can first borns be affected by ABO incompatibility?

Answer 10

yes bc mom already has anti-A and anti-B antibodies in blood

Question 11

What is the most common result of ABO incompatibility?

Answer 11

hyperbilirubinemia

Question 12

What procedure is done to detect fetal anemia intrauterine?

Answer 12

MCA-PSV

Question 13

What the indication for intrauterine transfusion?

Answer 13

if MCA-PSV shows hct <30%

Question 14

How is the infants blood type and Rh stauts determined at birth?

Answer 14

cord blood is sent to lab testing
-Coombs test is done to determine if it contains maternal antibodies

Question 15

What may be needed if there is severe hyperbilirubinemia?

Answer 15

exchange transfusion

Question 16

What language is crucial when communicating with parents who have experienced a loss?

Answer 16

simple, unambiguous, and consistent language

Question 17

What is appropriate to say to bereaved parents?

Answer 17

“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”

Question 18

What is NOT appropriate to say to bereaved parents?

Answer 18

“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”