Flashcards in Complications1-Table 1 Deck (312)
What causes physiologic anemia?
Normal changes in ratio of plasma to RBC volume
How is physiologic anemia reflected?
As decreased Hct d/t the dilutional effect relative to each trimester
What are lab findings associated with Iron def anemia?
What finding may accompany iron def anemia?
How is iron def anemia tx in preggo people?
Add an additional 60-80mg elemental iron daily
Why it taking folate a good idea?
Reduce the risk of NTD
How much dietary folate should be taken in?
400-800 mcg or 0.4-0.8mg
How much folate is in a prenatal vitamin?
What would indicate a need to increase daily folate to 4mg or 4000mcg daily?
- mom on anticonvulsants
-past hx of NTD pregnancy
What are hemoglobinopathies?
heterogeneous group of single gene disorders that include structural Hb variants
What is the Hb variant in sickle cell?
Hb A replaced with Hb S
What is sickle cell dz?
Unstable sickled shape to RBC
Increased viscosity and hemolysis
What is sickle cell trait?
Heterozygoutes Hb AS
What is isoimmunization?
Formation of maternal antibodies, aka maternal alloimmunization
What leads to hemolytic dz of the newborn?
Binding of maternal antibodies to fetal RBC antigens
What is hemolytic dz of the newborn characterized by?
Hemolysis, bili relsease, anemia
How is the severity of hemolytic dz of the newborn determined?
- how much antibody was produces
- how strongly antibody binds to antigen
- ability of the fetus to replenish the destroyed RBC
What are the 4 major blood groups determined by?
Presence or absence of A & B RBC surface antigens
What makes group A?
has A antigen on RBCs & B antibody in plasma
What makes group B?
has B antigen on RBCs & A antibody in plasma
What makes group AB?
has both A & B antigens on RBCs but neither A nor B antibody in plasma
What makes group O?
has neither A nor B antigens on RBCs but both A & B antibodies in plasma
What is the 3rd antigen? When is it a problem?
Rh (rhesus) factor
Either present + or absent –
Positive is ok, negative is an issue unless both mom and dad are negative
What is the Rh system composed of?
A complex of 5 antigens
C, c, D, E, e
What is the most common antigen? Hint its part of the Rh- CDE system
What is the deal with antigen D?
Present: Rh-D positive
Absent: Rh-D negative
Why is antigen D important?
There is isoimmunization potential when an Rh-D negative woman is preggo with a fetus that is positive!
How much Rh-D blood is sufficient to cause isoimmunization?
How does this work?
Maternal antibodies pass to baby via placenta and cause an antibody response that destroys fetal RBC