HDFN (After exam 1) Flashcards
Maternal perspective
what to detect?
DAT to detect if ab has attached to rbs
+ DAT on baby blood
HDFN
+ DAT on anyone
elution/AB id
Predictions
what testing?
ABO types?
Predict?
type and screen
ABO : O Neg mom more likely to have HDN than AB pos
predict what Ab mom could make
HDFN
what is destroyed by….
specific for ?
what sensitizes mother?
fetal rbcs destroyed by maternal Allo ab specifc for inherited paternal rbc ag
Fetal rbcs sensitize mother: trauma, delivery, abortion, medical intervention
O patients commonly make?
IgG A,B
Characteristics of HDFN Ab
can?
not absorbed?
causes? (efficient)
positive?
can cross placenta IgG
not absorbed by normal tissues
causes hemolysis: igG1/IgG3 efficient
+ on fetal cells
Ab in HDFN
common ab: A/B, D, Rh, Kell
Rare: duffy, Ss, Kidd, MN
Post partum testing: Mother
blood type and screen, Ab ID, betke…etc
Post partum testing: infant
blood type, DAT, elution
Followup test to maternal ID
Ab titer,
must to successive titers
Diagnosis/ management of HDFN
initial visit
hxt
Transfusion/pregnancy Hxt
type+screen
Rh status
Ab Id/ titration
Subsequent visits for management of HDFN
Ab titrations
ab panels
26-38 wk visits for management of HDFN
confirm ag neg of fetus.
rhogam admin if necessary
Rhogam
ONLY directed at ANTI-D, only for prevention not great for treatment
Lab monitoring/titration
Critical titer for Anti D
16-32 AHG phase
Critical for anti K
8
if a titer is <8, when may the next be preformed?
significant change?
next may be preformed every 4-6wk
sign change defined by diff of 2 dilutions
Significance of D
critical value?
extremely immunogenic
1mL can sensitize mother
Critical Value >16 TITER
Weak D test
serologically?
poly?
verify?
for?
serologically IS/AHG
polyclonal D
verify w saline
for donors or discrepency
Molecular
what panel?
females of….
Rh pos but?
SNP panel
females of child bearing age with Weak D
Rh pos but Anti D demonstrated
Rhogam continued
class
high
bleed?
criteria?
Rh immunoglobulin
high titer IgG anti-D
30 mL Bleed
Criteria: Rh neg
NO HXT OF ANTI D
Fetal maternal bleed screen
what formation
baby and mother rh status?
tests for?
negative results
positive results
rosettes, mother Rh =
baby Rh +
qualitiative test for the fetal maternal hemorrage
Negative results: <15mL bleed give standard dose
Positive: >15ml bleed, quantitate test for dose
Kleinhaur betke
what kind of test? (non) testing for?
equation?
quantitative test, fetal hgb non invasive
fetal cells/#maternal cells = % bleed
% bleed x maternal vol (5000/30) = dose + 1
FNA-TP
most common?
therapy?
causes?
HPA-AI
IVIG therapy
TP
ITP
prednisone
alloimmune
