Flashcards in Red Cell Iso-Immunization Deck (23):
2 kinds of antibodies
Auto-antibodies + fetus
Allo-antibodies, no damage to mother, damage fetus
Common maternal autoimmune
-Thyroid auto-immune: grave's
-Connective tissue diseases - SLE,
Schrogen's: Auto Rho, LA
-Fetus: heart block/cardiomyopathy
-Immune Thrombocytopenia Pupura
Red Cell Isoimmunisation
Perinatal allo-immune thrombocytopaenia
If no platelets, where does fetus bleed from?
Overwhelming bacterial infection.
In birth: ecoli, GBS, GAS
What to give baby with no white cells?
Why don't give baby with no white cells.... White cells?
Graft vs. Host
Harmful Red cell antigens
Rhesus c/C, d/D, E/e
Kell, Kidd, Duffy
What most important red cell antigen?
D +/-c,E (85%)
What happens in severe neonatal jaundice? From red cell haemolysis?
Kernicterus: permanent brain damage
Hydrops: cardiac failure
Primary immunisation? 3
1. Blood transfusion
2. Feto-Maternal haemorrhage
When does is feto-maternal haemorrhage happen?
Abortion, miscarriage, ectopics, Antepartum haemorrhage
CVS, Amnio, Version, MVA
How to protect against occult feto maternal haemorrhage?
Prophylactic Anti-D at 28&24 weeks (90%)
anti-body titre threshold?
Low risk ab titre?
Moderate ab titre?
Medium risk antenatal care?
U/s Screen at 20 weeks
-MCA peak systolic velocity
CTG at 32 weeks
Deliver at 38
Intrauterine transfusion, if need to give mother blood, can you do it?
Yes, only the red cells, no plasma, but in practice would use donor blood.
Most sensitive thing for hypovolaemia in young person?
Store what blood in hospitals for any woman of child-bearing age?
D -ve blood
Contraindication to passive-antiD?
If already imunised
Timing of Anti-D passive administration?
Within 72 hours