Isoimmunization

Question 1

Isoimmunization occurs when:

Answer 1

Mother is Rh -ve
Baby is Rh +ve
Fetomaternal hge

Question 2

Causes of fetomaternal hge:

Answer 2

APH
IUFD
Falls or closed abdominal trauma
ECV
Invasive prenatal diagnosis

Question 3

Antenatal investigations for RH- mothers:

Answer 3

blood Rh & ABO grouping
• If she -ve, Rh grouping for the husband.
• If husband also -ve, no problem
• if he is +ve, further investigations are to be carried out

Question 4

Save level of Anti-D in mother serum is

Answer 4

<4ui/ml

Question 5

Mother’s serum Anti-D level
>4 and <15 is a moderate risk of:

> 15:

Answer 5

Hemolytic disease of fetus and newborn (HDFN)

Severe HDFN

Question 6

S&S of isoimmunization:

Answer 6

Jaundic of baby
Poor feeding or lethargy
Erythroblastosis fetalis
HDFN

Question 7

Physiological jaundice of newborn

Answer 7

Appear after 24h
Maximum intensity by 4th-5th day
The serum level is less than 15mg/dl
Clinically not detectable after 14 days
Tx: phototherapy (in mild cases : daily sunlight)

Question 8

How ti prevent isoimmunization:

Answer 8

Prevent mothers from forming Anti-D antibodies by giving RhoGAM (anti-D antibodies)

Question 9

Indications for RhoGAM:

Answer 9

Miscarriage
Ectopic pregnancy
Conditions associated with FMH

Question 10

RhoGAM :Not indicated for

Answer 10

Complete spontaneous miscarriage <12 weeks
Threatened miscarriage <12 weeks with cessation of bleeding before 12 weeks
Reason: unlikely to cause significant FMH