RH INCOMPATIBILITY Flashcards
The Rh blood antigen, or Rh factor, is present on the
surface of erythrocytes of a majority of the
population
rh incompaitbility
The Rh positive gene is ___ & even
when paired with an Rh negative gene, the positive
gene takes over
dominant
___ (sensitization) occurs when an Rh-negative woman carries an Rh-positive fetus
rh alloimmunization
- The RBCs from the fetus invade the maternal circulation
→ production of Rh ___
antibodies
Rh antibodies cross the
placenta & enter the fetal circulation → severe ___
hemolysis
true or false: Rh incompatibility is a problem that affects the fetus; it causes no harm to the expectant mother
true
fetal neonatal risks:
CHF
hydrops fetalis
icterus gravis
kernicterus
erythoblastosis fetalis
a life-threatening condition that causes abnormal fluid buildup in a fetus or newborn
hydrops fetalis
any severe form of jaundice of unknown or doubtful origin occurring in a new-born infant
icterus gravis
a rare and serious brain condition that occurs in newborns when bilirubin levels in the blood are too high
kernicterus
a serious blood disorder that can occur when a mother and fetus have incompatible blood types. It can cause anemia in the fetus
Erythroblastosis Fetalis
determines whether there are
antibodies to the Rh factor in
the mother’s blood
antibody screening test / indirect coombs
normal / negative indirect coombs test result means?
mother has not developed antibodies
abnormal / positive indirect coombs test result means?
mother has developed antibodies and is sensitized
Antibody titer of greater than 1:4
The higher the second number, the more likely ___ is to be
affected.
baby
prophylactic given at 28 weeks if screen is negative
200 mcg RhoGAM
true or false: Rh immune globulin is also given after each abortion,
ectopic pregnancy, or amniocentesis.
true
If abortion or ectopic pregnancy occurs in the first
trimester, a smaller dose of Rh immune globulin (MICRhoGAM or Mini-Gamulin Rh) is used.
50 mcg
___ dose of RhoGAM is used following second trimester
amniocentesis.
full
Two primary interventions can help the fetus whose
blood cells are being destroyed by maternal antibodies:
early birth, intrauterine transfusion
Ultrasound should be done at ___ weeks to
determine gestational age, severe fetal involvement,
increase in fetal heart size & hydramios.
14-16 weeks
Measure ___ in fetus to predict fetal anemia
peak systolic - middle cerebral artery - velocity
___ is
performed to determine fetal hematocrit
percutaneous umbilical blood sampling (PUBS)
Severely sensitized fetuses may require birth at ___ weeks
32-34
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
____ of childbirth.
72 hours
