Rh

Question 1

What is the mode of inheritance of RH?

Answer 1

Dominant

Question 2

When does rhesus disease occur

Answer 2

Negative mother with

• positive child
• prev positive chile

Question 3

Define rhesus disease

Answer 3

Ab from mother attack ab of baby causing hemolysis

Question 4

When does mixing of baby blood and mothers occur

Answer 4

1- delivery of Rh+
2- abortion (more w/induced)
3- ectopic
4- invasive procedure
5- antepartum hemorrhage
6- trauma

Question 5

Is it possible for a women who had never been pregnant to be sensitised with rh

Answer 5

Yes by blood transfusions

Question 6

If a Rh-ve delivers Rh+, what to do?

Answer 6

AntiD within 72hrs post delivery

Question 7

What is the prophylaxis for a women whose Rh sensitized?

Answer 7

1- first trimester give 50mg of antiD

2- second and third give 300mg

Question 8

Why do we start giving antiD as early as the first trimester?

Answer 8

Blood production starts at 3 weeks and RH develops at 38d

Question 9

What happens if severe hemolysis occured with rheusus disease?

Answer 9

1- portal HTN, hepatomegaly, low albumin and anasarca
2- rbc production by liver and spleen
3- anemia and heart failure
4- polyhydraminos

Question 10

What is hydropz fetalis?

Answer 10

Generalized edema around heart placenta lung and abodmen

Question 11

If the mother is Rh-ve, and your anti-D titers are 0, what to do next?

(Assuming father is Rh +ve)

Answer 11

Give anti-D at 28weeks and at delivery

Question 12

If the mother is Rh-ve, and your anti-D titers are 0-1.4, what to do next?

(Assuming father is Rh +ve)

Answer 12

Repeat

• every 1m until 24weeks
• every 1w until delivery

Question 13

What if the anti-D titer was 0-1.4 and as you were repeating the test, you found no increase in the titer?

Answer 13

No action is needed

Question 14

What if the anti-D titer was 0-1.4 and as you were repeating the test, you found increase in the titer?

Answer 14

Do father genetic testing to assess if he is heterozygous or homozygous

Question 15

what to do if mother titer is >1.4 and the father is homozygous for Rh+ve

Answer 15

It means the baby is defiantly Rh positive!

• Do (MCAV - amniocentesis)

Question 16

If titer is >1.4 and the father is homozygous, you did the MCAV and amniocentesis and the results were as following

• MCA>1.5
• OD in the affected zone

Answer 16

Continue testing
- 1to2 wks until 32
- 1wk until 35
Assess lung maturation + OD at 35

Question 17

When to give rhogram in negative rh women?

Answer 17

• at 28 weeks and within 48 hours of birth
• positive klehauer betke test
• invasive procedure in pregnancy
• ectopic pregnancy and miscarriage
• APH & trauma