Isoimmunisation

Question 1

AN Mx of iso-immunisation

Scenario 1- 30yo anti-Kell on pre-preg bloods

Scenario 2 - previous abruption & blood transfusion, anti-Kell in new 16/40 pregnancy

Scenario 3 - recent PRBC postpartum, now found out to be have anti-Kell, implications for future preg

Answer 1

• F risk - anemia/hydrops/SB
• Blood transfusion
• Tertiary referral
• MDI - MFM/Haem
• Paternal genotype +/- fetal
  Pat geno KK - all offspring affected
  Pat geno Kk - 50% offspring - test fetus
  Pat geno kk - no offspring - no mx
• weekly MCA PSV >1.5MoM from 16/40
• antibody titer monitoring
• FBS+/- IUT +/- steroid load pre
• Del 37-38/40 if IUT or high titre
• MOD = obstetric indication
• Intrapartum = CEFM, Paeds
• Postpartum = cord FBE/G&S/Coombs/Bili