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IHBB > HDFN > Flashcards

HDFN Flashcards

1
Q

Most common HDFN

A

ABO HDFN

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2
Q

Most severe HDFN

A

Rh HDFN

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3
Q

HDFN

a.k.a Erythroblastosis fetalis

A

Immune destruction of fetal red cells due to maternal antibodies from previous pregnancy

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4
Q

Pathphysio - Hydrops fetalis

In utero

A

Pathophysiology - Hydrops Fetalis
1. Anemia
2. Increased red cell production
2. 1. Erythroblasts in circulation
2. 2. Decreased protein
3. ** Increased erythropoiesis** (liver & spleen)
4. Hepatosplenomegaly
4. 1. Hypertension & Hepatocellular damage
5. High output cardiac failure w/ edema, ascites, effusion.

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5
Q

Pathophysio - Neonatal HDFN

at birth

A

Pathophysio - Neonatal HDFN

  1. Increased B1 (no conjugation)
  2. Jaundice
  3. Kernicterus (18-20 mg/dL B1)
  4. Permanent brain damage
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6
Q

18-20 mg/dl

B1

A

can cause Kernicterus and permanent brain damage

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7
Q

Condition for HDFN to occur:
* Mother:
* Fetus:

A

Condition for HDFN to occur:
* Mother: Rh negative
* Fetus: Rh positive

Others: Mother must have IgG antibodies from previous pregnancy

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8
Q

Common HDFN antibodies

A

Anti-D (95%)
Anti-K
ABO antibodies

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9
Q

< 1 mL

A

volume of fetal RBCs can immunize the mother

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10
Q

ABO HDFN

  • First child:
  • Predictable:
  • Preventable:
  • Spherocytes:
A

ABO HDFN

  • First child: Affected
  • Predictable: No
  • Preventable: Yes
  • Spherocytes: Yes
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11
Q

Rh HDFN

  • First child:
  • Predictable:
  • Preventable:
  • Spherocytes:
A

Rh HDFN

  • First child: Not affected
  • Predictable: Yes (Titer)
  • Preventable: Yes
  • Spherocytes: Rare
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12
Q

Cord Blood

A

Sample to condirm HDFN

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13
Q

10-12 weeks

2nd trimester

A

Fetal DNA Testing

identify coding genes for the antigens which cause HDFN

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14
Q

Saline Antiglobulin Tube Test

A

methos in antibody titer determination of HDFN

predict severity of HDFN

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15
Q

>16 Ab Titer

A

Critical Titer

proceed with proper management
2nd titer should be done at **18-20 weeks

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16
Q

> 32 Ab titer

A

Indicates to color doppler imaging

17
Q

Antibody Titer
* >16
* >32

A

Antibody Titer
* >16 - Critical Titer
* >32 - indicates Color doppler imaging

18
Q

O.D. 450

Collection: Amniocentesis & Cordocentesis

A

Bilirubin Testing

estimates the extent of fetal hemolysis

19
Q

Middle Cerebral Artery-Peak Systolic Velocity (MCA-PSV) Ultrasonography

Predict anemia

A

based on the reduced viscosity at low hematocrit resulting to faster velocity

20
Q

18-20 weeks

A

Amniocentesis for O.D. 450

21
Q

HDFN Management

Intrauterine Transfusion

Transfusion of fetus in utero

A

Transfusion of PRBCs to the fetus (in utero) to **correct anemia **

22
Q

Indication - Intratuterine Transfusion

A

Indication - Intratuterine Transfusion (one or more condition)
* Hemoglobin <10 mg/dL
* MCA-PSV indicates anemia
* Fetal hydrops on ultrasound
* High zone **(Zone II/Zone III) **in O.D. 450

23
Q

Purpose - Intrauterine transfusion

A

Maintain >10 mg/dL of fetal hemoglobin

24
Q

Exchange Transfusion

Transfusion of newborn infant

A

Removal maternal antibody and antigen negative RBCs to correct anemia and hyperbiliribunemia

25
Q

0.5mg/dL/hr rise in bilirubin or 10 mg/dL in first 24 hrs

A

Indication for exchange transfusion

26
Q

Requirements - Neonatal Transfusion
* Type:
* Unit:
* Negative:
* Treatment:

A

Requirements - Neonatal Transfusion
* Type: Group O negative
* Unit: <7 days
* Negative: CMV, Hb S
* Treatment: Irradiated (prevent GVHD)

27
Q

<7 days

A

Unit life span for exchange transfusion

28
Q

460-490 nm

A

Phototherapy

29
Q

Remove bilirubin and prevent kernicterus in newborn

A

Exchange transfusion

30
Q

Antenatal administration - RhIg

A

28 weeks or early 3rd trimester

31
Q

Postnatal RhIg administration

A

72 hrs of delivery

32
Q

Shelf-life RhIg

A

2 years

33
Q

Full dose Rh0gam
* Anti-D:
* Protection:

A

Full dose Rh0gam
* Anti-D: 300ug
* Protection: WB - 30 ml; pRBC - 15 ml

34
Q

Mini/Micro dose Rh0gam
* Anti-D:
* Protection:

A

Mini/Micro dose Rh0gam
* Anti-D: 50 ug of anti-D
* Protection: WB - 5 ml; pRBC - 2.5 ml

35
Q

Qualitative Fetal screen

A

Fetal screen Rosette method

36
Q

Quantitative Test for Fetal blood

A

Flow Cytometry
Kleiahauer Betke acid eultion Test

IHBB (11 decks)

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