RH And Pregnancy Flashcards
The Rh blood antigen, or Rh factor, is present on the surface of erythrocytes of a majority of the population
RH Incompatibility
Rh factors are _____ determined
RH factors follow a common pattern of ______ _________
1.) Genetically
2.) Genetic Inheritance
• If a person has the genes + +, the Rh factor in the blood will be _____.
• If a person has the genes + -, the Rh factor will be _____.
• If a person has the genes - -, the Rh factor will be _____
1.) Postive
2.) Positive
3.) Negative
Rh Alloimmunization occurs when____
An RH negative women carries a RH positive Fetus
OR
An Rh negative nonpregnant woman receives an RH positive BT
The RBC’s from the fetus invade the _____
In a subsequent pregnancy, RH antibodies cross the placenta and enter the fetal circulation resulting into ____
1.) Maternal Circulation resulting in production of RH antibodies
2.) Severe Hemolysis
Rhesus factor incompatibility is possible only when two specific circumstances coexist:
1.) Expectant Mother is RH negative
2.) Fetus is RH positive
1.) May occur in other cases such as elective or spontaneous abortions or even during antepartal procedures
2.) A rapid immune response against RH positive blood occurs with extensive_____
1.) Sensitization
2.) Fetal Maternal Hemorrhage
RH incompatibility is a problem that affects the _____ and not the mother
Fetus
Fetal neonatal Risks:
1.) Congestive Heart Failure
2.) Hydrops Fetalis (Fetal Edema)
3.) Icterus Gravis (Jaundice)
4.) Kerniceterus (Neurologic Damage)
At the first prenatal visit, caregivers…
Take a history of previous
1.) Sensitiation
2.) Abortions
3.) Blood transfusions
Children who developed Jaundice or anemia
At the first prenatal visit, caregivers:
1.) Determine maternal blood type
2.) Identify other medical complications
determines whether there are
antibodies to the Rh factor in
the mother’s blood
Antibody Screening Test
ANTIBODY SCREENING TEST:
1.) Mother has not developed antibodies against the fetus blood
2.) Mother has developed antibodies to the fetal RBC’s and is sensitized
1.) Normal (Negative) Result
2.) Abnormal (positive) Result
This tells how many times there is a need to dilute the blood to get rid of the antibodies.
Antibodies Titer of greater than 1:4 POSTIVE
• If the antibody screen
obtained at 28 weeks’
gestation is negative, woman
is given 300 mcg of Rh
immune globulin (RhoGAM)
IM as a prophylactic
(preventive) measure
Antepartal Management
If woman is Rh (-) (not sensitized) & the father is Rh (+) or unknown:
Antepartal Management
• Rh immune globulin is also given after each abortion, ectopic pregnancy, or amniocentesis.
If abortion or etopic pregnancy occurs in the _____ trimester, a smaller (_____mcg) dose of RH immune globulin is used
1.) 50mcg
2.) First trimester
2 primary interventions can help the fetus whose blood cells are being destroyed by maternal antibodies
1.) Early Birth
2.) Intrauterine Transfusion
Ultrasound should be done at __ and __ weeks to determine gestational age, severe fetal involvement
14-16 weeks
Non invasive clinical test for the prediction of fetal anemia
Middle Cerebral Artery (MCA)
Preformed to determine fetal hematocrit
Severely Sensitized fetuses may require birth at 32-34 weeks
Percutaneous Umbilical Blood Sampling (PUBS)
The Rh-negative mother who has no antibody
titer (indirect Coombs’ test negative,
nonsensitized) & has given birth to an Rh-positive fetus (direct Coombs’ test negative) is given an
IM injection of RH immune globulin (RhoGAM) within 72 hours of childbirth
• Explain the purpose of the Rh immune globulin administered at ____
weeks’ gestation if the woman is not sensitized
• Note that Rh immune globulin provides ________
1.) 28 weeks
2.) Passive Immunity
