Red Cell Antibodies Flashcards
in IUFD where no sample can be obtained from the baby
prophylactic anti-D Ig within 72h of the diagnosis of IUfD, irrespective of the time of subsequent delivery
Do we give anti d in case of miscarrage
below 12 weeks no need for anti D (NICE)
*heavy recurrent bleeding and pain 250 anti-d - BCSH)
Indication of anti-d for non sensitized RH-ve women after birth?
500 IU within 72 hours w/ KBT
Routine antenatal Anti-D prophylaxis time & dose
- at 28 and 34 (500lU)
- or once At 28 (1500IU)
the most common encountered antibody during pregnancy
Anti-D
Do ART increases the risk of red cell alloimmunisation
No evidence
prevelence of positive antibody screens
1:80
prevelence of clinically significant alloantibodies other than anti-d
1-300
if at booking testing we find clinically significant antibody screen positive
we test for anti- DcK antibodies monthly until 28 weeks then from 28 w test twice weekly until delivery
after delivery test cord blood for : DAT, Hb, billirubin
if at booking testing we find clinically significant antibody screen positive other than DcK
repeat antibody screen at 28 w till delivery then test cord blood for DAT, Hb, bilirubin
if at booking testing we didn’t find clinically significant antibody screen positive
repeat antibody screen at 28 w till delivery
Cut-off for DcK antibodies
Anti-D: 4 iu/ml
Anti-c: 7.5 iu/ml
Anti-K: if positive
What may Anti-K do attacking the fetus
erythropoeisis suprression leading to severe fetal anemia (even in at low ab titre)
no hyperbilirubinemia
when to undertake genotyping for anti DcK
all at 16 weeks
Anti-K at 20 weeks
don’t do genotyping unless antibody reaches threshold
when to refer for FMU in case of Anti-DcK found
- rising AB above threshold
- U/S suggest of fetal anemia
- Hx of unexplained severe neonatl jaundice, anemia requires transfusion or exchange transfusion, to exclude HDFN as the cause
