Red Cell Iso-Immunization Flashcards
2 kinds of antibodies
Auto-antibodies + fetus
Allo-antibodies, no damage to mother, damage fetus
Common maternal autoimmune
-Thyroid auto-immune: grave’s
-Connective tissue diseases - SLE,
Schrogen’s: Auto Rho, LA
-Fetus: heart block/cardiomyopathy
-Immune Thrombocytopenia Pupura
3 iso-antibodies
Red Cell Isoimmunisation
Perinatal allo-immune thrombocytopaenia
Perinatal neutropenia
If no platelets, where does fetus bleed from?
GI
Intracranial
Neutropaenia
Overwhelming bacterial infection.
In birth: ecoli, GBS, GAS
What to give baby with no white cells?
Abx
IgG
Why don’t give baby with no white cells…. White cells?
Graft vs. Host
Harmful Red cell antigens
Rhesus c/C, d/D, E/e
Kell, Kidd, Duffy
MNS
What most important red cell antigen?
D +/-c,E (85%)
Kell, c,E,Fya
What happens in severe neonatal jaundice? From red cell haemolysis?
Kernicterus: permanent brain damage
Hydrops: cardiac failure
FDIU
Primary immunisation? 3
- Blood transfusion
2. Feto-Maternal haemorrhage
When does is feto-maternal haemorrhage happen?
Abortion, miscarriage, ectopics, Antepartum haemorrhage
CVS, Amnio, Version, MVA
Spontaneous
How to protect against occult feto maternal haemorrhage?
Prophylactic Anti-D at 28&24 weeks (90%)
anti-body titre threshold?
> 512
Low risk ab titre?
Moderate ab titre?
64-256
Medium risk antenatal care?
U/s Screen at 20 weeks
-MCA peak systolic velocity
CTG at 32 weeks
Deliver at 38
Intrauterine transfusion, if need to give mother blood, can you do it?
Yes, only the red cells, no plasma, but in practice would use donor blood.
Most sensitive thing for hypovolaemia in young person?
Postural hypotension
Store what blood in hospitals for any woman of child-bearing age?
Kell -ve
D -ve blood
Contraindication to passive-antiD?
If already imunised
Timing of Anti-D passive administration?
Within 72 hours
Anti-D what kind of ab?
IgG
Won’t harm baby because titre is too low
