Term
| What are the 2 types of HDN? |
|
Definition
|
|
Term
| What is the Most common type of HDN? |
|
Definition
|
|
Term
| Can ABO HDN occur in the first pregnancy? |
|
Definition
|
|
Term
True or False:
ABO HDN is usually NOT very serious clinically |
|
Definition
|
|
Term
| Do ABO HDN need transfusions or exchanges? |
|
Definition
| Almost never need transfusion much less exchange |
|
|
Term
True or False:
ABO HDN - Anemia and Jaundice if present are mild |
|
Definition
|
|
Term
| What is elevated in ABO HDN, but rarely goes above 14 mg/dL? |
|
Definition
|
|
Term
| What will you often see on ABO HDN baby's blood smear? |
|
Definition
|
|
Term
True or False:
ABO incompatibility may protect against anti-D HDN |
|
Definition
|
|
Term
| Small bleeds occur during ____% of pregnancies |
|
Definition
|
|
Term
True or False:
IgG HDN - Baby's spleen will destroy all cells coated with ABY and the baby will become anemic |
|
Definition
|
|
Term
| What is Hydrops fetalis characterized by? |
|
Definition
| edema related to severe anemia |
|
|
Term
| What is the cause of IgG HDN? |
|
Definition
| Baby's RBCs enter maternal circulation |
|
|
Term
True or False:
IgG HDN - Larger bleeds capable of inducing sensitization usually occur at the time of delivery when the placenta tears away |
|
Definition
|
|
Term
Clinical effects of HDN -
Inutero what is the main problem? |
|
Definition
|
|
Term
Clinical effects of HDN -
Why is anemia the main problem inutero? |
|
Definition
| Mom's liver conjugates the bilirubin produced by breaking RBCs |
|
|
Term
Clinical effects of HDN -
After birth, anemia is still a problem, but what is of greater concern? |
|
Definition
|
|
Term
| In the baby, elevated levels of what cause kernicterus? |
|
Definition
|
|
Term
| You should do a blood exchange at what amount of indirect bilirubin for a term infant? |
|
Definition
|
|
Term
| What are the 2 types of IgG HDN? |
|
Definition
|
|
Term
| Which of the 2 types of IgG HDN is the most severe? |
|
Definition
|
|
Term
True or False:
Anti-D IgG HDN can only occur in second pregnancy unless Rh negative mom received a prior transfusion with Rh positive blood |
|
Definition
|
|
Term
| With Anti-D IgG HDN what will the baby's DAT be? |
|
Definition
|
|
Term
True or False:
Anti-D IgG HDN often requires inutero transfusion and exchange transfusion after delivery |
|
Definition
|
|
Term
True or False:
Any significant system AGN is capable of inducing an antibody in the mom and causing HDN |
|
Definition
|
|
Term
True or False:
If the maternal's IAT is positive, you must perform a panel to identify the ABY |
|
Definition
|
|
Term
| If the mother has an anti-D what must be done? |
|
Definition
|
|
Term
| ___ tube increase is considered significant |
|
Definition
|
|
Term
| A single titer of _____ is considered significant |
|
Definition
|
|
Term
| If the mom has a rising anti-D titer, what may be indicated? |
|
Definition
Amniocentesis
Cordocentesis
Spectral Scan |
|
|
Term
| The Most Serious outcome is if ______ is high early in pregnancy (zone 3 or top zone on Liley graph) |
|
Definition
|
|
Term
If ____ ____ indicates HDN:
Deliver baby as soon as L/S ratio indicates lung maturity
In utero transfusion
Follow mom closely |
|
Definition
|
|
Term
| What does PUBS stand for? |
|
Definition
| Percutaneous umbilical blood sample |
|
|
Term
| With PUBS what do you check to assure that the blood is really on the baby? |
|
Definition
|
|
Term
| What must the MCV be to assure that the blood is really from the baby? |
|
Definition
|
|
Term
| What 3 tests do you perform with PUBS? |
|
Definition
|
|
Term
| What should you blood be like for a Intrauterine transfusion? |
|
Definition
O = or type compatible with mom & baby
AGN = of ABY causing HDN
CMV =, fresh, irradiated |
|
|
Term
| For Intrauterine transfusions you should crossmatch with whose serum? |
|
Definition
Mom's Serum
Baby's Serum
Eluate |
|
|
Term
| If you are doing a Newborn Workup and you use the cord blood what is something you are likely going to have to do? |
|
Definition
| Extra washings to get rid of Wharton's Jelly |
|
|
Term
True or False:
If intrauterine transfusion was done, baby forward type may be almost impossible to determine |
|
Definition
|
|
Term
| How many times should the Newborn workup DAT be washed? |
|
Definition
|
|
Term
| Newborn workup - What do you do if DAT is positive? |
|
Definition
|
|
Term
| What type of Eluate is BEST for ABO HDN? |
|
Definition
|
|
Term
|
Definition
Wash cells, freeze, thaw to release ABY into solution
React eluate with the following cells at 37 degrees Celsius and AHG |
|
|
Term
ABO HDN -
DAT on Baby is _____
Mom's IAT is ______ |
|
Definition
|
|
Term
| What can be used to treat ABO HDN? |
|
Definition
|
|
Term
| Will the Rh control be + or = if +DAT unless one used monoclonal Anti-D because it will be detected at RT? |
|
Definition
|
|
Term
| When the mom's Anti-D is VERY Increased what could be inhibiting testing? |
|
Definition
|
|
Term
| What Eluate is BEST for Rh and Other ABYs? |
|
Definition
| (Digitonin) Elu II or ether |
|
|
Term
| What do you perform Elu II or ether? |
|
Definition
| When baby has positive DAT, the mom's IAT is positive, and the blood types do not indicate ABO HDN |
|
|
Term
True or False:
Baby with Anti-D HDN can type as Rh = if all the D AGN sites are covered by maternal Anti-D |
|
Definition
|
|
Term
| If _____ is eluted from baby's cells, one can assume that the baby is D positive |
|
Definition
|
|
Term
Eluate plus A= RBC Reaction +
Interpretation: ______ |
|
Definition
Anti-A, Anti-B, or Anti-A,B
ABO HDN |
|
|
Term
Eluate plus B= RBC Reaction +
Interpretation: ______ |
|
Definition
ABO HDN
Anti-A, Anti-B, or Anti-A,B |
|
|
Term
Eluate plus O+ RBC, Reaction +
Interpretation:_______ |
|
Definition
|
|
Term
| When would an exchange transfusion be performed? |
|
Definition
| Baby is anemia and Bilirubin is High |
|
|
Term
| Indirect bilirubin of _____ or HIGHER will cross the blood brain barrier |
|
Definition
|
|
Term
| Will an Exchange Transfusion raise or lower Bilirubin? |
|
Definition
|
|
Term
True or False:
Exchange Transfusion will remove Maternal ABYs and damaged RBCs |
|
Definition
|
|
Term
True or False:
Exchange Transfusion will provide normal RBCs for O2 carrying |
|
Definition
|
|
Term
| What type of blood do you use for Exchange Transfusions? |
|
Definition
Packed cells mixed with Compatible FFP
ABO compatible
AGN = for Mom's ABY |
|
|
Term
| Should the ABO & FFP be compatible with the mom's or the baby's RBCs for Exchange transfusions? |
|
Definition
|
|
Term
| Exchange Transfusion - Double Crossmatch using what? |
|
Definition
| Mom's serum & Baby's serum or eluate |
|
|
Term
| What is the procedure for Exchange Transfusion? |
|
Definition
Remove a small amount of baby's blood
Exchange with BB blood |
|
|
Term
| What is the MOST Common reason for Neonatal transfusion? |
|
Definition
| Replace Blood drawn for lab tests |
|
|
Term
True or False:
Exchange Transfusion - If IAT is =, crossmatch is NOT required as long as ABO compatible |
|
Definition
|
|
Term
Exchange Transfusion - Units Transfused -
Must be fresh (under ___ days old) |
|
Definition
|
|
Term
Exchange Transfusion - Units Transfused -
Must be CMV = for all babies under ______ grams |
|
Definition
|
|
Term
Exchange Transfusion - Units Transfused -
Must be ____ to prevent TA-GVHD in immunologically impaired preemies |
|
Definition
|
|
Term
| What should you use instead of Adsol for Exchange Transfusion? |
|
Definition
|
|
