Fetal Blood Type and Rh Factor Monitoring

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What is the purpose of routine prenatal and postpartum testing?

To diagnose, monitor, and treat Hemolytic Disease of the Fetus and Newborn (HDFN)

How does ABO HDFN compare to Non-ABO HDFN?

ABO HDFN and Non-ABO HDFN are compared and contrasted

What are the potential outcomes of Hemolytic Disease of the Fetus and Newborn?

Miscarriage, stillbirth, and early death

Why is the terminology for prenatal and postnatal care considered outdated?

Because it is gendered Signup and view all the answers

What tests are used to determine fetomaternal hemorrhage?

Tests used for the determination of fetomaternal hemorrhage are compared and contrasted Signup and view all the answers

How is the RhIg dosage calculated?

The RhIg dosage is calculated using a specific process Signup and view all the answers

What is the purpose of using non-gendered terms in healthcare?

To be more inclusive and reflect the patients that are served. Signup and view all the answers

What is the terminology used for studies related to pregnancy and childbirth?

Mom/Baby Studies Signup and view all the answers

When is the PRENATAL TYPE AND SCREEN (PREN) performed?

Performed early in the pregnancy Signup and view all the answers

What is the policy for weak D testing in UWMC laboratory?

Test for weak D if there is an ABO/Rh discrepancy or the Anti-D is weakly positive Signup and view all the answers

When is RhIg administered?

All pregnancies: Antepartum at 28 Weeks if one of the following occurs: miscarriage, abortion, trauma (fall or accident), or invasive procedure (examples: IUT, amniocentesis, repositioning). Within 72 hours of delivery if the baby is D pos or weak D pos or fetal Rh is unknown. Patient is not already sensitized to D antigen. Signup and view all the answers

What is the purpose of performing an antibody ID Titer?

To determine if the antibody is IgG and clinically significant (capable of causing HDFN) Signup and view all the answers

What are the routine prenatal and postpartum tests for Hemolytic Disease of the Fetus and Newborn (HDFN)?

The routine prenatal and postpartum tests for HDFN consist of ABO/Rh typing, antibody screen, and antibody identification if indicated. Signup and view all the answers

What are the lab findings for ABO HDFN?

ABO HDFN has different lab findings but the same effect on the baby. Signup and view all the answers

What are the lab findings for Non-ABO HDFN?

Non-ABO HDFN has different lab findings but the same effect on the baby. Signup and view all the answers

What is the purpose of the qualitative Fetomaternal Hemorrhage (FMH) screen?

The qualitative FMH screen is used to determine the presence of fetal red blood cells in the maternal circulation. It can only be used on Rh negative parents. Signup and view all the answers

What is the purpose of the Kleihauer-Betke/Flow Cytometry test?

The Kleihauer-Betke/Flow Cytometry test is used to quantify the amount of fetomaternal hemorrhage in any Rh parent. Signup and view all the answers

How is the number of RhIg vials calculated?

The number of RhIg vials is calculated based on the volume of Rh positive blood exposure to the mother. Signup and view all the answers

What are the action levels for anti-K using the tube method?

≥8 Signup and view all the answers

What are the action levels for anti-K using the gel method?

more sensitive and will have different action levels Signup and view all the answers

What are the indications for performing intrauterine transfusion (IUT)?

Change in optical density at 450nm is in Zone III or high Zone II of the Liliey graph, Cordocentesis hemoglobin is less than 10 g/dL, Fetal Hydrops is noted on ultrasound examination, Twin to Twin transfusion Signup and view all the answers

What are the requirements for the blood used in IUT?

Reasoning: Irradiated (freshly irradiated is best), Leukoreduced, Fresh (<5 days old or <7 facility dependent), O Neg (Parental blood can be used in case of high prevalence antibody), Antigen Compatible with Parent, Hgb S negative, Possible Modification: Washing or Supernatant removed Signup and view all the answers

What are the challenges for testing newborns?

Risk of parental contamination, Wharton’s Jelly Cannot be blood type of record, Newborns in general Mixed field in ABO, Did the parent undergo IUT during pregnancy, Interference from Parental antibody Signup and view all the answers

What is the procedure for performing an elution?

Typically acid elution or Lui Freeze/Thaw elution, Performed on baby's red blood cells, Test elution with antibody screen and panel, Add type specific cells if ABO incompatibility is suspected Signup and view all the answers

What is the purpose of the Rosette Test in fetal bleed screening?

The Rosette Test is used to detect fetal blood in the parent's blood sample. Signup and view all the answers

What are the limitations of the KB stain in fetal bleed screening?

The KB stain is not very precise, time-consuming, and can have staining issues. It may also result in confusion between fetal cells and lymphocytes. Additionally, if the parent has increased Hgb F levels, the test results may be falsely elevated. Signup and view all the answers

How does RHIG administration work?

RHIG administration works by blocking or hindering the immune response, clearing out RBCs instead of stimulating the immune system, and creating an immunostat response where the body thinks it has already made antibodies. Signup and view all the answers

How is the dose of RHIG calculated?

The dose of RHIG is calculated using the formula: (number of fetal cells / number of parent's cells) * 100 * 50 = fetal bleed volume. The fetal bleed volume is then divided by 30 and rounded up to the nearest whole number to determine the number of vials of RHIG to give. Signup and view all the answers

What are the antibodies of concern in hemolytic disease of the fetus and newborn?

The antibodies of concern in hemolytic disease of the fetus and newborn are Anti-A, Anti-B, Anti-A,B, Anti-D, Anti-c, Anti-E, and Anti-K (most significant after Rh). Signup and view all the answers

What are the monitoring and treatment options for anemia and high bilirubin levels in the newborn?

Monitoring of anemia and high bilirubin levels in the newborn can be done through measuring total bilirubin levels and using bili-lights. If bilirubin levels exceed 25 mg/dl and bili-lights are not effective, an exchange transfusion may be required as a last resort. Signup and view all the answers