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DMST 285 OBGYN 2 > Maternal Diseases: Hematologic Disorders > Flashcards

Maternal Diseases: Hematologic Disorders Flashcards

1
Q

What are some hemotaologic disorder examples? 3

A
  1. Rh isoimmunization
  2. Sickle cell anemia
  3. Heterozygous thalassemia
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2
Q

Rh isoimmunizartion is a hematologist disease of what?

A

Newborns

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3
Q

What disease does Rh isoimmunization typically lead to?

A

Eryhtroblastosis fetalis

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4
Q

How does RH isoimmunization happen? 2

A
  1. Mom (Rh-) develops antibodies to surface antigens on fetal (Rh+) red blood cells
  2. Mom’s antibodies attack and destroy fetal red blood cell
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5
Q

What is erythroblastosis fetalis?

A

Rapid destruction of fetal red blood cells

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6
Q

What happens as a result of erythroblastosis fetalis? 2

A
  1. Outpouring of many new blood cells to compensate for the RBC destruction
  2. The immature RBCs do not support or carry oxygen well
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7
Q

When is RH isoimmunization usually prevalent?

A

Only in 2nd and subsequent pregnancies

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8
Q

Why is RH isoimmunization on the decline?

A

Because of the introduction of preventative maternal immunologic blocking treatments

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9
Q

What are some complications of RH isoimmunization? 5

A
  1. Hepatosplenomegaly
  2. Jaundice
  3. Kernicterus
  4. Congestive heart failure
  5. Edema
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10
Q

What is kernicterus?

A

Bilirubin in fetal blood destroys brain and spinal cord tissues

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11
Q

What is the most severe form of RH isoimmunization? And what does it look like?

A
  1. When RH isoimmunization becomes immune hydrops fetalis.
  2. Fluid overload seen as pleural effusion and ascites in the fetus
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12
Q

What is the maternal management of RH isoimmunization?

A

Rh- mothers will be given an injection of Rh immunoglobulin (WinRho or RhoGam) in first pregnancy at 28-32 weeks and again after delivery (within 72 hours)

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13
Q

What does the RH immunoglobulin injections do for RH isoimmunization?

A

It will prevent the formation of antibodies in the mother

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14
Q

What are some other indications for administering WinRho in the RH- patients? 4

A
  1. Spontaneous abortion (72 hours)
  2. Therapeutic abortion
  3. Ectopic pregnancy after aminocentesis
  4. Maternal hemorrhage, vaginal bleeding in pregnancy
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15
Q

Should we give an injection to a RH+ mother?

A

Never

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16
Q

What is the fetal assessment for Hemolytic disease?

A

BPP and Biometry in fetal assessment units

17
Q

When we asses for anemia, what does it look like sonographically? 2

A
  1. Ascites appears first as echogenic bowel
  2. Pleural effusion/ pericardial effusion
18
Q

When we do doppler of the MCA what do we see? 3 (What do we measure? >1.5 MoM means what? what do we need to do?)

A
  1. Peak velocity of the MCA is measured
  2. > 1.5 multiples of median (MoM) would indicate severe anemia in the fetus
  3. Fetal blood transfusion would be required
19
Q

What are some things we do in sonography for hemolytic diseases? 3

A
  1. Fetal assessment
  2. Assessing for anemia
  3. Doppler of the MCA is performed
20
Q

How does someone get sickle cell anemia?

A

It is an inherited disorder

21
Q

Which demographic of individuals is most affected by sickle cell anemia? 2

A
  1. People of African descent
  2. Can also affect those central/ South America, Caribbean islands, Mediterranean countries, India and Saudi Arabia
22
Q

What does sickle cell blood cells look like?

A

Sickle shaped

23
Q

What is the disadvantage of sickle cell anemia?

A

Poor fit in capillaries and small vessels resulting in anemia

24
Q

What are some possible complications of sickle cell anemia? 2

A
  1. Maternal death
  2. Spontaneous abortion
25
Q

How common is heterozygous thalassemia?

A

It is one of the most common autosomal recessive genetic abnormalities associated with pregnancy

26
Q

Where does heterozygous thalassemia occur? What does it do?

A

The mutation occurs on the same gene as sickle cell and reduces hemoglobin production

27
Q

What does heterozygous thalassemia result in? 2

A
  1. Anemia
  2. Can lead to non- immune hydrops and death

DMST 285 OBGYN 2 (15 decks)

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