Chapter 36 Flashcards
What causes hemolytic disorders in newborns
Hemolytic disorders occur when maternal antibodies are present naturally or form in response to an antigen from the fetal blood crossing the placenta and entering the maternal circulation.
What are the most common causes of hemolytic disease of newborn
ABO Incompatibility – most common
Rh(D) Incompatibility – second most common
what is Rh incompatibility
Rh-positive offspring of an Rh-negative mother are at risk
Mother forms antibodies (called maternal sensitization) that then destroy fetal red blood cells (hemolysis)
Results can be mild (fetal jaundice) or severe (Erythroblastosis fetalis, Hydrops fetalis)
what is ABO incompatibility
Fetal blood type is A, B, or AB, and the maternal type is O
Naturally occurring anti-A and anti-B antibodies are transferred across the placenta to the fetus
Exchange transfusions required occasionally
what is erythroblastosis fetalis
Hemolytic anemia in fetus
what is hydrops fetalis
hemolysis that causes large amount of fluid buildup in tissues and organs
what is an exchange transfusion
take out blood from neonate and exchange the blood
what will be done if mom is rh negative
want to know that in prenatal visits
if pregnancy is normal at around 29 weeks mom will get rhogam shot
normal delivery process, baby will be tested, if baby is rh negative then nothing happens
if baby is positive then give rhogam within 72 hrs after delivery
what happens if mom is rh positive
nothing happens
what is rh immune globulin
commercial preparation of passive antibodies against the Rh factor; destroys any fetal RBCs in the maternal circulation and blocks the maternal antibody production
when is rh immune globulin given
Give to all Rh-negative mothers at 28 weeks of gestation; within 72 hours after delivery & anytime there is a risk of fetal-maternal hemorrhage
what are the critical tests for hemolytic disease
indirect Coombs
anti-D titer
MCA-PSV
cord blood at brith
direct Coombs test
serial bilirubin
what is the indirect Coombs test
test done on maternal blood, positive, increased risk for hemolytic anemias
what is the direct Coombs test
from cord blood, positive coombs means increased risk of jaundice, anemia
what causes rhogam to be given
Rhogam is given any time of potential blood crossing
fetal demise, miscarriage, abortion
what are the most common congenital anomalies that cause serious issues
Congenital heart disease
Neural tube defects
Cleft lip or palate
Clubfoot
Developmental dysplasia of the hip
how much folic acid should be taken daily
400 mcg
what are the types of CNS anomalies (neural tube defects
Encephalocele
Anencephaly
Spina Bifida (Occulta, Manifesta)
Meningocele; myelomeningocele
Hydrocephalus
Microcephaly
what is an encephalocele
disorder in which the bones of skull do not close completely, which createsa gap where CSF fluid, meninges can protrude in sac like form
what is anencephaly
major part , the absense of both cerebral hemispheres and of overlying skull
what is spina bifida occulta
milder, laminae failure to close, spinal cord or meninges do not protrude through defect , no abnormality of spinal cord, meninges, or nerve roots
what is meningocele
sac may be covered by thin layer of skin , meninges and spinal cord extend thru an irregular vertebrae opening
what is a myelomeningocele
no layer of skin covering sac, most common form of spina bifida, spine is exposed
what is hydrocephalus
build up of fluid
