Question | Answer |
Define HDN and list the 3 types | ABO, Rh and other alloantibodies Mainly Kell but can be kidd, duffy, et.c |
Hemolytic Disease of the Newborn is a disease characterized by | the destruction of fetal/newborn RBCs resulting from the placental transfer of maternal alloantibody. |
Fetal-maternal hemorrhage is | passage of red cells from the mother to the fetal circulation as a result of placental transfer or at delivery. |
Extramedullary erythropoiesis is | production of red cells outside the bone marrow. |
Antepartum | before delivery |
Postpartum | after delivery |
Kernicterus | a grave condition resulting in the passage of bilirubin into the brain and spinal cord. |
Toxic levels of bilirubin in a newborn’s brain during the first 2 to 8 days of life, can cause | permanent brain damage; |
any level > 18mg/dL | |
Hydrops fetalis | clinical condition in infants characterized by cardiac insufficiency with resultant edema and respiratory distress. |
Erythroblastosis fetalis | hemolytic disease associated with anemia, jaundice, spleenomegaly, edema, and the presence of immature red cells in the circulation (erythroblasts). Another name for HDN. |
B19 parvovirus | causes fifths disease. Red cheeks, no treatment, there is vaccine. Can cause spontaneous abortion . |
With ABO HDN it can happen when | with the first pregnancy. |
Immediate hemolytic reaction | TX of incompatible RBC/whole blood; anti-A, Kell, Jka, Fyasymptoms = intravascular = fever, oliguria, anuria, death, nausea, back or chest pain, vomitingprevention = follow all procedures/policies to ensure safe |
Delayed hemolytic reaction | secondary response to transfused RBC Symptoms = fever, chills, mild jaundice Prevention = thorough medical history documenting any previous TX, pregnancies, transplants |
Febrile reaction | antileukocytic antibodies in patient’s plasma Symptoms = 1 C rise in temperature associated with TX and having no medial explanation other than TX |
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Anaphylactic or anaphylactoid reaction | anti-IgA in patient’s plasma Symptoms =occur after TX of only a few ml of plasma or plasma-containing components;coughing, breathing trouble, hives, chest pain, shock, death Prevention = total plasma removal |
Allergic reaction | allergen complexes = histamine release Symptoms =redness,itching and hivesPrevention = pre-medicate with Benadryl |
Bacterial contamination | endotoxins produced by bacteria capable of growing in cold; Pseudomonas, E. coli and Yersinia enterocolitica Symptoms = “warm” reaction; dryness and flushing of skin |
Prevention | strict adherence to component collection, storage, handling and preparation procedures, visual observation of units, Tx within standard maximum allowable time limit = 4 hours |
Circulatory Overload | massive TX at too fast a rate Symptoms = breathing trouble, coughing, cyanosis, headache Prevention = slow rate of TX = 100mL/hr; aliquot blood |
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Name three reactions considered to be delayed non-hemolytic reactions | Post-transfusion purpura TX-associated graft-versus-host disease Iron overload |
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Name four diseases transmitted by blood. | Hepatitis B, C HIV HTLV-I/II West Nile Virus |
Describe kernicterus | toxic levels of bilirubin in a newborn’s brain that causes permanent brain damage |