RH-ISOIMMUNIZATION 🖤

Question 1

Definition of isoimmunization

Answer 1

is the process of formation of antibodies against constituent of the tissue of another individual of the
same species .

Question 2

Antigen O what’s the antibodies?

Answer 2

AntiA+Anti B

Question 3

Who is universal donor?

Answer 3

O

Question 4

Antigen A what’s the antibodies?

Answer 4

Anti B

Question 5

Antigen B what’s the antibodies

Answer 5

Anti A

Question 6

Who is universal receptions?

Answer 6

AB

Question 7

What’s the dominant antigen?

Answer 7

C,D,E.

Question 8

What’s the recessive antigen?

Answer 8

d,e

Question 9

If the mother have the Rh - and the father Rh + and the future has Rh +

Answer 9

The antibodies for the second fetus will be attack the RBCs of the fetus
if the second fetus has Rh +

Question 10

Normally the maternal circulation and the fetal circulation are kept away from direct contact with each other, with gas and nutrient exchange taking place across a membrane in the placenta made of two layers:

Answer 10

syncytiotrophoblast and the cytotrophoblast

Question 11

When fetal maternal hemorrhage happened

Answer 11

When the membrane ceases.
Fetal Rh + and maternal Rh-

Question 12

What’s the can lead to leakage of the fetuse celks to the maternal circulation? 10

Answer 12

• Spontaneous abortion.
• Induced abortion.
• APH.
• E.C.V.
• Cordocentesis, CVS, amniocentesis
• Severe preeclampsia
• Ectopic pregnancy
• Caesarean section
• Manual removal of placenta
• Silent feto-maternal haemorrhage .

Question 13

Kleihauer-Betke technique?

Answer 13

measure amount of feto-maternal hemorrhage

Question 14

How you can measure amount of feto-maternal hemorrhage?

Answer 14

By Kleihauer-Betke technique

Question 15

What’s the steps to do Kleihauer-Betke technique

Answer 15

1. acid elution test (( separation feature from the maternal blood ))
2. in 50 low power microscopic field
   of peripheral maternal blood (( 5 fetal cells)).
3. RhGAM IG 500 IU ( 300 mcg ) > 15ml -30ml fetal red cells.

Question 16

Rh ISOIMMUNIZATION
Mild Cases

Answer 16

fetal (RBC) destruction → from anti-D (IgG): → anaemia → compensating
haemopoiesis → excess of unconjugated bilirubin
• excess of unconjugated bilirubin > (310-350 mol/L) → It passes brain barrier → (kernicterus) → permanent neurological and mental disorders

Question 17

Rh ISOIMMUNIZATION
Severe Cases:

Answer 17

excessive destruction of fetal (RBC) → severe anaemia → hypoxia the tissues → cardiac or circulatory failure → generalized edema → (H. failure) → ascitis → IUFD

Question 18

What’s the test you can used to screening Rh

Answer 18

Indirect coomb’s test

Question 19

What’s the time you will do Indirect coomb’s test ?

Answer 19

1. At booking.
2. Before 28 weeks.

Question 20

If not sensitized,
what’s the treatment ?
and when ?
and what’s the dose ?
what’s the method?

Answer 20

RhoGAM or Anti D
*500IU 28-34wks
Or
*1500 28 wks
Post natal <72 hrs if missed ( 10-14 days)
IM Deltoid

Question 21

The risk for isoimmunization
(( جدول ))

Answer 21

-

Question 22

If sensitized close monitoring of ? 2

Answer 22

1. Fetus
2. anti D level.

Question 23

How do you get a management or treatment for the risk of the pregnancy of Rh ISOIMMUNIZATION
?جدول

Answer 23

جدول

Question 24

Non-invasive fetal monitoring

Answer 24

1. Ultrasound of fetal hydrops.
   - Ascites.
   - pleura effusion.
   - soft tissue/ scalp oedema.
   - cardiomegaly.
   - hepatomegaly.
2. Doubler (( middle cerebral artery.))
3. FKC
4. CTG