Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y4R2 - Obstetrics I 🤰 > L9-11: Rh Isoimmunization, ABO Incompatability & Fetal Hydrops > Flashcards

L9-11: Rh Isoimmunization, ABO Incompatability & Fetal Hydrops Flashcards

1
Q

def of Rh Isoimmunization

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Synonyms of Rh Isoimmunization

A
  • Erythroblastosis fetalis
  • Hemolytic disease of newborn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rh Isoimmunization

  • Rh Factor
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rh Genes

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most Important Rh gene

A

D gene → Rh +ve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Rh +ve person

A

homozygous (DD) or heterozygous (Dd).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rh -ve person

A

only homozygous (dd).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rh Antigens

A

5 Ags (C, D, E, c, e) on surface of RBCs (no lower d Ag).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Incidence of Rh Isoimmunization

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Incidence of Rh Isoimmunization

  • Rh -ve persons
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Incidence of Rh Isoimmunization

  • Rh Isoimmunization
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Incidence of Rh Isoimmunization

  • the great difference () incidence of Rh -ve persons & incidence of Rh isoimmunization is explained by
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Etiology of Rh Isoimmunization

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Etiology of Rh Isoimmunization

  • Any contact () Rh + ve fetal blood & maternal circulation
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Etiology of Rh Isoimmunization

  • Blood transfusion of Rh +ve blood to Rh -ve female at any age
A

…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pathogenesis of Rh Isoimmunization

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pathogenesis of Rh Isoimmunization

  • Which Antigen?
A
  • 95% of cases of isoimmunization are caused by maternal sensitization against Rh Ag D however, other Rh Ags (C & E) may rarely initiate isoimmunization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  • Once Rh isoimmunization has been initiated, the individual produces large amounts of Abs (2ry response) in response to small amounts of fetal blood.
A

…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

pathogenesis of Rh Isoimmunization

  • Amount of Blood Needed
A

As little as 0.25 ml of fetal Rh +ve cells can lead to isoimmunization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

pathogenesis of Rh Isoimmunization

  • Type of Abs
A
  • Initially, anti-Rh IgM Abs are formed (it has large MW so, don’t cross placenta & don’t cause hemolysis of fetal RBCs).
  • This is followed by the formation of anti-Rh IgG Abs that cross placenta → destruction of fetal RBCs.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CP of Rh Isoimmunization

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CP of Rh Isoimmunization

  • Degrees
A
  • Congenital hemolytic anemia: Mildest form
  • Icterus gravis neonatorum: Commonest form
  • Fetal hydrops: Rarest & most severe form
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

CP of Rh Isoimmunization

  • Congenital hemolytic anemia
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

CP of Rh Isoimmunization

  • Icterus gravis neonatorum
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
CP of **Rh Isoimmunization** - Fetal Hydrops
25
Dx of **Rh Isoimmunziation**
- Hx - Rh Typing - Indirect Coombs Test - US - X-Ray - Spectrophotometric analysis of AF - Fetal blood sampling - Neonatal blood sampling
26
Dx of **Rh Isoimmunziation** - Hx
1) Past history: Previous blood transfusion. 2) Obstetric history: Previous affected baby or IUFD which may be recurrent.
27
Dx of **Rh Isoimmunziation** - Rh Typing
28
Dx of **Rh Isoimmunziation** - Indirect Coombs Test
29
Indirect Coombs test in **Rh Isoimmunziation** - Aim
Detection of presence of anti-Rh Abs in maternal serum & determination of level of these Abs.
30
Indirect Coombs test in **Rh Isoimmunziation** - Technique
31
Dx of **Rh Isoimmunziation** - US
32
Dx of **Rh Isoimmunziation** - X-Ray
33
Dx of **Rh Isoimmunziation** - Spectrophotometric analysis of AF
34
Spectrophotometric analysis of AF in **Rh Isoimmunization** - Aim
- Determination of AF bilirubin level that reflects degree of fetal RBCs hemolysis.
35
Spectrophotometric analysis of AF in **Rh Isoimmunization** - Indications
36
Spectrophotometric analysis of AF in **Rh Isoimmunization** - Procedure
- Amniocentesis & sample of 5-10 ml of AF is taken. - Protect specimen from light as it decolorizes bilirubin. - Spectrophotometric analysis of AF
37
Spectrophotometric analysis of AF in **Rh Isoimmunization** - Interpretation
38
Spectrophotometric analysis of AF in **Rh Isoimmunization** - Liley Graph
39
Fetal Blood Sampling in **Rh Isoimmunization**
40
Fetal Blood Sampling in **Rh Isoimmunization** - Aim
41
Fetal Blood Sampling in **Rh Isoimmunization** - Procedure
Through cordocentesis.
42
Fetal Blood Sampling in **Rh Isoimmunization** - Indication
- AF bilirubin level is in high zone 2 or zone 3 on Liley graph. - Instead of amniocentesis before 26 weeks (AF analysis isn't reliable at this age).
43
Fetal Blood Sampling in **Rh Isoimmunization** - Disadvantages
Complications of cordocentesis: 1. More risky than serial amniocentesis. 2. Feto-maternal Hge & consequently, massive ↑↑ in concentration of Abs. 3. Thrombosis of umbilical vessels. 4. Risk of fetal death (1.5%).
44
Neonatal Blood Sampling in **Rh Isoimmunization**
45
Neonatal Blood Sampling in **Rh Isoimmunization** - Aims
- ABO grouping & Rh typing. - Hb level & Hct value. - Number of reticulocytes & nucleated RBCs. - Serum bilirubin level. - Direct Coombs test.
46
Neonatal Blood Sampling in **Rh Isoimmunization** - Procedure
Taking 10 ml of cord blood immediately after birth
47
DDx of **Rh Isoimmunization**
48
Prevention of **Rh Isoimmunization**
- Prevention of blood transfusion errors - Anti-D Ig administration
49
Prevention of **Rh Isoimmunization** - Prevention of blood transfusion errors
Never to give Rh +ve blood to Rh -ve females.
50
Prevention of **Rh Isoimmunization** - Anti-D Ig administration
51
Anti-D Ig administration in **Rh Isoimmunization** - Value
Anti-D Ig will destroy Rh +ve RBCs in maternal Circulation before sensitization.
52
Anti-D Ig administration in **Rh Isoimmunization** - indications
53
Anti-D Ig administration in **Rh Isoimmunization** - time of adminstartion
Within 72 hours after sensitizing event.
54
Anti-D Ig administration in **Rh Isoimmunization** - Calculation of Dose
55
Principle of Kleihauer-Betke acid elusion test
56
Plan managment in **Rh Isoimmunization** - Algorithm
57
Managment of **Rh Isoimmunization** - If Rh -ve husband
No need for further testing
58
Managment of **Rh Isoimmunization** - if Rh +ve husband - US Showing fetal hydrops
- cordocentesis & IUT then delivery after lung maturity
59
Managment of **Rh Isoimmunization** - Rh +ve Husband - -ve indirect Coomb's test
Repeat at 20, 24 & 28 weeks → if remain -ve: 1. Antepartum anti-D Ig at 28 & 34 2. Allow spontaneous delivery. 3. Postpartum anti-D Ig if neonate is
60
Managment of **Rh Isoimmunization** - Rh +ve Husband - +ve indirect coomb's test below critical level
61
Managment of **Rh Isoimmunization** - Rh +ve Husband - +ve indirect coomb's test >= critical level
62
Intrauterine transfusion (IUT) in **Rh Isoimmunization**
62
Lines of Managment of **Rh Isoimmunization**
1. **Management during pregnancy:** - IUT - Adjuvant methods to ↓↓ fetal hemolysis 2. **Management of delivery** 3. **Neonatal Care**
63
Intrauterine transfusion (IUT) in **Rh Isoimmunization** - indications
- Fetal hydrops - significant fetal anemia (Hb deficit > 2 gm/dl from mean for normal fetuses or Hct value < 30%).
64
Intrauterine transfusion (IUT) in **Rh Isoimmunization** - Types
65
Intrauterine transfusion (IUT) in **Rh Isoimmunization** - Type of Blood
- O -ve blood compatible with maternal blood (the best for severely hydropic fetuses is packed RBCs).
66
Intrauterine transfusion (IUT) in **Rh Isoimmunization** - Calculation of amount needed
1) ml/gm of fetal weight. 2) (GA in weeks - 20) x 10.
67
Adjuvant methods to ↓↓ fetal hemolysis in **Rh Isoimmunization**
**Have no value** a. Promethazine therapy. b. Plasmapheresis. c. Immunosuppressive agents.
68
Management of delivery in **Rh Isoimmunization** - Time of Delivery
See plan of management.
69
Management of delivery in **Rh Isoimmunization** - Method of Delivery
Either VD or CS depending on fetal condition.
70
Management of delivery in **Rh Isoimmunization** - Precautions
71
Neonatal Care in **Rh Isoimmunization**
72
Neonatal Care in **Rh Isoimmunization** - Care of Preterm
....
73
Neonatal Care in **Rh Isoimmunization** - exchange Transfusion
74
Neonatal Care in **Rh Isoimmunization** - Indications of Exchange Transfusion
75
Neonatal Care in **Rh Isoimmunization** - Type of Blood in Exchange Transfusion
Fresh Rh -ve blood of homologous ABO group.
76
Neonatal Care in **Rh Isoimmunization** - Amount of Blood in exchange transfusion
80 cc / pound body weight.
77
Neonatal Care in **Rh Isoimmunization** - Phototherapy
in mild cases to decolorize yellow color of skin in jaundiced babies.
78
Neonatal Care in **Rh Isoimmunization** - Phenobarbitone
May be used to ↑↑ hepatic bilirubin conjugation.
79
Pathophysiology of **ABO Isoimmunization**
Women with blood group O may have anti-A & anti-B Abs from early life which may be augmented by pregnancy.
80
Incidenece of **ABO Isoimmunization**
20% of all infants have ABO maternal blood group incompatibility however, only 5% of them show overt signs of hemolytic disease.
81
Prevention of **ABO Isoimmunization**
ABO isoimmunization isn't preventable but it is always much milder than Rh isoimmunization.
82
CP of **ABO Isoimmunization**
83
Criteria to Dx **ABO Isoimmunization**
84
Another Name of **Fetal Hydrops**
Hydrops Fetalis
85
Def of **Fetal Hydrops**
Presence of excess fluid in ≥ 2 body areas (as thorax, abdomen & skin).
86
Classification of **Fetal Hydrops**
87
Def of **Non-Immune Fetal Hydrops**
88
Incidence of **Non-Immune Fetal Hydrops**
1/1700 pregnancies
89
Etiology of **Non-Immune Fetal Hydrops**
90
Dx of **Non-Immune Fetal Hydrops**
91
Done
...

Y4R2 - Obstetrics I 🤰 (59 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions