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HDN contintued

Serologic testing, transfusion, RhIg & ABO HDN

Serologic testing for newborn ABO & Rh typing; DAT; Eluate
Serologic testing for mother antibody screen & compatibility testing
Newborn transfusion aliquots or exchange depending on severity
Exchange used to remove high levels of indirect bili & prevent kernicterus; more likely in premature infants
Exchange transfusion removes maternal AB and sensitized RBCs' replaces incomp with complete RBCs; suppresses erythrpoiesis
Blood selection Group O, Rh neg, reconstituted with AB plasma; CMV neg, irradiated, HgS neg, less than 7 days old, AG neg for corresponding AB
RH Immune Globulin high titered RhIg, anti-D admined by IM injection; anti-D attaches to fetal D pos RBCs; AB coated cells caught in spleen & removed from circulation suppressing production of anti-D by mother
Indications for RhIg Rh neg, weak D neg, unsensitized mother immed after delivery of Rh pos baby or unknown blood type; give within 72 hours
Indications for RhIg cont @ 28 weeks to Rh neg, weak D neg, unsensitized mother; abortions or etopic pregnancies
RhIg dosage & administration 1 vial for 15ml of RBCs or 30ml whole blood; massive FM of >30ml more than 1 vial given
RhIg dosage & administration cont screen for large FHM performed on mothers blood using rosette test; if positive a quantitative test done- Kleihauer-Betke, used to calculate anount of RhIg
Other considerations RhIg of no benefit of mother has anti-D; must not confuse RhIg anti-D with active immunity and vice versa
Other considerations cont must not interpret large amount of fetal D pos cells in circulation with weak D pos
ABO HDN IgG ABO AB cross placenta & attach to fetal RBCs; mild to moderate hyperbilirubinemia; exhcange transfusion rare; most common cause of HDN, 1:5
Created by: dodge1500