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Flashcards in Rhesus DIsease Deck (12)
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1

What d moes it mean to be Rhesus negative?

RhD - means that the red blood cells do not carry RhD antigen

 

If RhD- woman is carrying RhD+ foetus and any foetal blood cross into maternal circulation (sensitizing event) → maternal reaction to the 'foreign D' antigens on RBCs of the foetus → antibodies anti D are produced → problem not in a current pregnancy but in a later ones (antibodies from mum may cross the placenta and destroy foetal RBCs)

This leads to haemolytic disease of newborn and either severe disability or stillbirth 

2

When to do routine anti-D prophylaxis for women that are RhD-?

at 28 weeks, 34 weeks and if after a baby is born and its blood is tested as RhD + then we also give postnatal anti-D prophylaxis

3

How does anti-D prophylaxis work?

  • Anti-D prophylaxis prevents RhD- women from producing anti-D antibodies against RhD+ foetus

 

  • This is achieved because anti-D immunoglobulins are already provided (so immune system of the mum does not need to produce a new ones)

4

What's a sensitizing event?

An event when a foetal blood could pass into maternal circulation

5

What are the doses of anti-D prophylaxis: 

  • before 20 weeks gestation
  • after 20 weeks gestation

  • before 20 weeks: 250 iu
  • after 20 weeks: 500 iu

6

Timing and route of anti-D prophylaxis after a sensitizing event has occurred

  • give ASAP after a sensitising event (ideally within 72 hours)* still some protection if given within 10 days
  • IM injection

7

Do we give prophylactic anti-D to RhD- women following abortion?

Yes. This is regardless of abortion being medical or surgical → we give anti-D for both

8

Do we give anti-D prophylaxis to non-sensitised RhD- women in case of ectopic pregnancy?

Yes

9

Do we give anti-D prophylaxis to non-sensitised RhD- women in case of spontaneous miscarriage?

Yes. To all types of miscarriage after 12 weeks pregnancy

(given even for threatened miscarriage)

* if miscarriage occurred before 12 weeks of gestation → then anti D not required; unless uterine evacuation was performed

10

In what cases, we should give anti-D prophylaxis to RhD- women?

  • ectopic pregnancy
  • miscarriage (after 12 weeks)
  • termination of pregnancy
  • antepartum haemorrhage 
  • closed abdominal injury
  • external cephalic version of foetus
  • invasive prenatal diagnosis (amniocentesis, foetal blood sampling)
  • other intrauterine procedures (
  • intrauterine death 

11

How much of anti D prophylaxis do we give to RhD- woman after she gave birth to RhD + child?

500 iu of anti - D within 72 hours

(postnatal) 

12

If mum is RhD- and dad is RhD- do we need to give anti-D prophylaxis?

No