These slides will discuss the hemolytic disease of the newborn generally , especially the RH incompatibility between mother and child and their effects ..

3. .

15. Fetal red blood cells antibodies attack hemolysis

18. Anti AAnti BAnti BAnti A
O Blood Type AB Blood TypeB Blood TypeA Blood Type
A+ B+ A+ B+ A+ B+ A+ B+
Anti A Anti B Anti B Anti A

19. Rh –ve mother
Rh +ve husband Rh –ve husband
antibody
Anti-Dtreatment
-ve
+ve

30. anti-D

31. routine
FMH

37. The following recommendations apply to
women who are Rh(D)-negative and whose
fetus is, or may be, Rh(D)-positive:
We recommend routine administration of
anti-D immune globulin early in the third
trimester . The optimum dose regimen in
the United States is
. This practice reduces
the incidence of antenatal isoimmunization
%.

38. We recommend administration of antenatal
anti-D immune globulin when there is an
increased risk of fetomaternal hemorrhage.
Some examples include miscarriage,
abortion, ectopic pregnancy, multifetal
reduction, amniocentesis, chorionic villus
sampling, blunt abdominal trauma, external
cephalic version, antepartum bleeding, and
fetal death. We administer 300 micrograms.

39. Repeat dosing for situations where there may be
an ongoing risk for fetomaternal hemorrhage (such
as chronic placental abruption or placenta previa
with intermittent vaginal bleeding) can be
managed with serial determinations of the
maternal indirect Coombs every three weeks with
repeat dosing if it is found to be negative.
We recommend administration of anti-D immune
globulin within 72 hours of delivery of an Rh(D)-
positive infant. We administer 300 micrograms and
also test for excessive fetomaternal hemorrhage in
case additional doses are needed.

40. If anti-D immune globulin is inadvertently omitted
after delivery, we recommend giving it as soon as
possible after recognition of the omission . Partial
protection is afforded with administration within 13
days of the birth, and there may be an effect as
late as 28 days after delivery.
.

41. within 72 hours of delivery to
a postpartum nonsensitized
Rh-negative woman.
all Rh-negative nonsensitized
women at 28 week of
gestation.
Bleeding
Early :
ectopic pregnancy
Abortion
Molar pregnancy
APH :
Placenta brevia
Abruptio placenta
Vasa brevia
invasive prenatal
procedures
amniocentesis
chorion villus
sampling
fetal blood
sampling
external version of
the fetus
abdominal
trauuma
At riskRoutine