Rhesus isoimmunisation Flashcards
1
Q
Rh incompatibility
A
Mother = Rh -ve (15% women) foetus = Rh +ve
Foetal RBCs enter maternal CVS - mother develops anti-Rh antibodies –> cross palcenta –>< haemolytic anaemia of foetus
2
Q
Sensitising events
A
TOP Evacuation of uterus Ectopic pregnancy Vaginal bleeding <12 weeks Invasive uterine procedure e.g. CVs, amniocentesis Intra-uterine death Delivery
3
Q
management
A
Give anti-D at 28 weeks and after ptentially sensitising events (72hrs)
Assess severity:
Doppler of foetal middle cerebral artery, foetal blood smapling to confirm
all babies born to Rh -ve women should have their cord blood tested:
- Coombes test - determines Ab on babies RBC
- Kleihauer test - quantifies amount of foetal RBC in maternal blood (if >5mls, mother requires additional anti-D)
Treat affected foetus - transfusions, UV phototherapy
Postnatal: check FBC, billirubin and Rh group