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CCHS SBB > RhIg > Flashcards

RhIg Flashcards

1
Q

why do most cases of HDFN due to anti-D occur in Caucasian females?

A

12-18% Caucasian females are D negative

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2
Q

most common cause of fetal-maternal hemorrhage

A

delivery

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3
Q

what percent of Rh negative people seem incapable of producing anti-D regardless of how many exposures to the D antigen?

A

~30%

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4
Q

causes of fetal-maternal hemorrhage

A 
delivery
amniocentesis
spontaneous or induced abortion
chorionic villus sampling
cordocentesis
rupture of ectopic pregnancy
blunt trauma to abdomen
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5
Q

what pregnancy is affected by fetal-maternal bleed?

A

second and subsequent

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6
Q

high-titer IgG D antibodies of human origin commercially prepared for injection IM or IV

A

Rh Immune Globulin

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7
Q

incidence of anti-D when RhIg is given at 28 weeks antepartum and postpartum

A

0.1%

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8
Q

who is a candidate for RhIg?

A

pregnant Rh negative women with no detectable immune anti-D
Rh negative women with no detectable immune anti-D who have delivered an Rh positive or weak D positive newborn
Rh negative female who receives platelets or red cells from Rh positive donor

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9
Q

RhIg dose calculation if given Rh positive blood products

A

vials needed = vol of bleed x Hct / 15

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10
Q

RhIg non-candidates

A

Rh positive
Rh negative women who deliver Rh negative babies
Rh negative women known to have made anti-D (active/immune)

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11
Q

anti-D from RhIg may be detected in antibody screen for how long after injection?

A

up to 6 months

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12
Q

expected titer of anti-D due to RhIg

A

<16

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13
Q

does RhIg cross placenta?

A

yes but no risk to hemolyze

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14
Q

can RhIg cause positive DAY at birth?

A

yes

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15
Q

when is RhIg administered?

A

after any invasive procedure
28 weeks
postpartum within 72 hours after delivery

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16
Q

amount of anti-D in one vial of RhIg

A

300 ug

17
Q

1 vial of RhIg covers what volume of fetal bleed?

A

30 mL whole blood

15 mL packed cells

18
Q

screening test for fetal-maternal hemorrhage

A

Rosette test/fetal bleed screen

19
Q

what does Rosette test detect?

A

Rh positive cells

20
Q

mechanism of fetal bleed screen

A

D+ indicator cells form rosettes around D+ fetal cells

21
Q

is fetal bleed screen qualitative or quantitative?

A

qualitative

22
Q

steps of rosette test

A

incubating mother’s red cell suspension with reagent anti-D
washing
D positive indicator cells added
examined microscopically for rosettes of indicator cells surrounding antibody-coated Rh positive cells

23
Q

confirmation test for fetal-maternal hemorrhage

A

Kleihauer-Betke

24
Q

when is KB test performed?

A

fetal bleed screen is positive

25
Q

what does KB test detect?

A

fetal cells

26
Q

is KB test qualitative or quantitative?

A

quantitative

27
Q

what do fetal cells look like in KB test?

A

bright pink

28
Q

what do maternal cells look like in KB test?

A

“ghost” cells

29
Q

how many cells are counted in KB test?

A

2000

30
Q

what test is used to determine fetal-maternal hemorrhage is mother is weak D positive?

A

KB

31
Q

RhIg dose calculation (fetal bleed)

A

% fetal cells x 50 / 30

32
Q

mL fetal hemorrhage calculation

A

KB percent x 50

33
Q

what safety margin is recommended for fetal maternal hemorrhage when giving RhIg?

A

add 1 to calculated number of vials

34
Q

when is mini or micro dose of RhIg given?

A

before 13 weeks gestation after miscarriages or abortions

35
Q

how is flow cytometry used in fetal-maternal hemorrhage?

A

uses reagent containing monoclonal antibody to hemoglobin F

36
Q

requirement of AABB standards in regards to fetal-maternal hemorrhage

A

a test to detect FMN is excess of 30 mL be employed to determine if multiple doses of RhIg should be admininstered

CCHS SBB (40 decks)

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