*Rhesus disease Flashcards
What might happen if a RhD negative woman carries a RhD positive fetus?
She may produce antibodies against the fetal RhD antigens following a fetomaternal haemorrhage
These may pass through the placenta in the current and future pregnancies and cause haemolytic disease of the newborn (HDN)
When is prophylactic Anti-D given?
28/40
34/40
Within 72 hours of a senstising event (any vaginal bleeding, abdominal trauma, birth)
Within 72 hours of birth if baby is Rh positive
Screen for antibodies first
How does Anti-D work?
It prevents the mum from creating antibodies and launching an immune response against the baby’s (potential) rhesus positive blood
Following a sensitising event, it destroys RhD positive blood cells that may have crossed into the maternal bloodstream
Rhesus disease: How should women be screened?
At booking, offer test for blood group, rhesus status and antibodies
If antibodies present, refer to MFM
Measure every 4 weeks, then fortnightly after 28 weeks
Postnatal protocol for rhesus disease (HDN)
- Kleihauer to detect fetal cells in maternal circulation
- Baby’s blood is taken for blood group, Rh factor, and DAT - to detect maternal red cell antibodies
- Anti-D to be given within 72 hours of birth if baby is Rh positive
HDN stands for
Heamolytic Disease of the Newborn
What drug, dose and route is given to Rh negative women?
Prophylactic Anti D / Rh(D) Immunoglobulin VF
625IU
IM into deltoid or quadriceps muscle
When administering Anti D what steps should you take?
Antibody screen prior to 28 wk dose
Confirm maternal consent
Should occur in a place where resus equipment is available
Adminster IM into deltoid or quadriceps muscle using normal checking procedure
What is offered postnatally to a Rh negative woman?
Maternal bloods taken for Kleihauer (within 72 hours of birth) to check for fetal cells in maternal circulation
Baby’s blood is taken for
* Blood group
* Rh factor
* Direct Antiglobulin Test (DAT)
Anti-D given within 72 hours of birth if baby is Rh positive
