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24 Cards in this Set
- Front
- Back
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what is Rh isoimmunization?
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mother is Rh negative and baby is Rh positive so mothers immune system begins attacking the baby
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what antigen is most common to cause Rho isoimmunization?
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D
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what is erythroblastisis fetalis?
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hemolytic anemia of the newborn, which occurs when the mother's immune system attacks fetal RBCs
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what is hydrops fetalis?
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a consequence of hemolytic anemia in which abnormal amounts of fluid build up in the fetus causing liver swelling, ascities, and effusion
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what are the 2 exposures of Rh?
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1st exposure causes production of IgM
2nd exposure, IgG is produced which can cross the placenta and damage the fetal RBCs |
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what are risk factors for transplacental hemorrhage/indications for giving Rho-GAM?
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abortion in the 1st trimester
trauma or vaginal bleeding in the 2nd or 3rd trimesters |
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when should the mother's Rh status be tested initially?
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all prednant women at their first prenatal visit
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if the mother is Rh negative, what is the next step?
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test the father
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if the father is Rh + and mother is Rh - what should happen next?
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she should be retested at 28 weeks gestation
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when should a more detailed fetal assement of Rh be taken?
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if titers rise above 1:16
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what is aminotic fluid spectrophotometry and when is it tested?
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used to detect the amount of fetal bilirubin via light
used at 27 weeks |
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what is the lily chart?
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used to interpret the change in optical density of bilirubin to correlate with the fetal hemoglobin level
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when is there an increaed risk for miscarriage with aminocentiesis?
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when it is performed prior to 15 weeks
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what is the role of serial ultrasonic examination of the fetus?
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useful in pregnancies at risk for hemolytic disease to confirm fetal well being
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what are ultrasound findings for hydrops fetalis? (4)
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ascities
pleural effusion pericardial effusion skin edema |
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what is percutaneous umbilical blood sampling used for? (5)
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used to measure
hematocrti hemoglobin blood gas pH bilirubin |
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what is the kleuhauer betke test?
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a good way to test the extent of feto-maternal hemorrhage
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what 4 treatments are available in Rh sensitive patients?
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intrauterine transfusions
intravascular transfusions plasmapheresis phenobarbitol |
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what is intrauterine transfusion?
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infusing the fetus with O group, Rh negative cells
survival rate is 85% |
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what is intravascular infusion?
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inserting a needle into the umbilical vein and infusing blood based on fetal body weight
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what is maternal plasmapheresis?
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removal, treatment, and return of maternal blood
used in severe cases where fetal infusion is not helpful |
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what is phenobarbitol?
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given to induce fetal hepatic enzyme maturation so that the fetus can process bilirubin and excrete it
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who/when should Rho-GAM be given?
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all pregnant, Rh negative and D negative women at 28 weeks at 300ug
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what are 5 other reasons to administer Rho-GAM?
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abortion
ectopic pregnancy significant vaginal bleeding at any age abdominal trauma at any gestational age partial molar pregnancy |
