Rhesus disease of the newborn

Question 1

Which women do not need any treatment for rhesus?

Answer 1

Rhesus positive women

Question 2

Which women need treatment for rhesus?

Answer 2

Rhesus negative women

Question 3

Why is anti-D given?

Answer 3

A rhesus negative woman can produce antibodies if she has a rhesus positive baby

In a subsequent pregnancy, the antibodies from mum can pass through the placenta and attack the baby’s blood cells

Question 4

What condition can be caused in a rhesus negative mother and rhesus positive baby?

Answer 4

If the mother has produced rhesus antigens, these can attach to the baby’s red blood cells and cause haemolytic disease of the newborn

Question 5

How does anti-D work?

Answer 5

If attaches itself to any fetal antigens in the mother’s bloodstream causing them to be destroyed. This prevents the mother’s response of creating antibodies to the blood cell antigens

Question 6

When is anti-D primarily given?

Answer 6

At 28 weeks gestation and at birth

Question 7

In what other situations is anti-D given?

Answer 7

Any time where mixing of blood could occur:
- Antepartum haemorrhage
- Amniocentesis
- Abdominal trauma
- Ectopic pregnancy
- Miscarriage
- Termination
- Intrauterine death
- External cephalic version
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Question 8

Within how long shoud anti-D be given after an exposure event?

Answer 8

72 hours

Question 9

What is the Kleihauer test?

Answer 9

A test to check how much fetal blood has passed into the mother’s bloodstream during a sensitisation event

Question 10

How is Kleihauer’s test performed?

Answer 10

Acid is added to a sample of blood
Adult blood cells are haemolysed by the acid, but fetal red blood cells remain and can be counted