Podcast
Questions and Answers
In which trimester is RhoD immunoglobulin routinely administered?
In which trimester is RhoD immunoglobulin routinely administered?
- Any trimester
- Third trimester (correct)
- First trimester
- Second trimester
What is the standard dose of RhoD immunoglobulin administered?
What is the standard dose of RhoD immunoglobulin administered?
- 300 micrograms (correct)
- 150 micrograms
- 500 micrograms
- 200 micrograms
What is the purpose of the Kleinhauer-Betke (KB) test?
What is the purpose of the Kleinhauer-Betke (KB) test?
- To identify potential complications in pregnancy
- To monitor the efficacy of RhoD immunoglobulin administration
- To determine the Rh status of the fetus
- To quantify the volume of fetal red blood cells in the maternal circulation (correct)
What is an exception to RhoD immunoglobulin administration in pregnancy?
What is an exception to RhoD immunoglobulin administration in pregnancy?
When is RhoD immunoglobulin most effective?
When is RhoD immunoglobulin most effective?
What is the maximum volume of fetal blood that a standard dose of RhoD immunoglobulin can protect against?
What is the maximum volume of fetal blood that a standard dose of RhoD immunoglobulin can protect against?
What procedures are commonly associated with the potential for maternal-fetal blood mixing?
What procedures are commonly associated with the potential for maternal-fetal blood mixing?
Women with high hemoglobin and hematocrit values during pregnancy might experience which of the following?
Women with high hemoglobin and hematocrit values during pregnancy might experience which of the following?
What is a potential impact of anemia on pregnancy?
What is a potential impact of anemia on pregnancy?
Which of the following is NOT a potential impact of anemia on pregnancy?
Which of the following is NOT a potential impact of anemia on pregnancy?
Which of the following is a potential cause of early labor initiation?
Which of the following is a potential cause of early labor initiation?
How can heritable anemias impact pregnancy?
How can heritable anemias impact pregnancy?
What is the largest contributing factor to anemia during pregnancy?
What is the largest contributing factor to anemia during pregnancy?
Which of the following is a potential consequence of fetal hypoxia?
Which of the following is a potential consequence of fetal hypoxia?
What is the primary reason for the high percentage of maternal deaths attributed to anemia in developing countries?
What is the primary reason for the high percentage of maternal deaths attributed to anemia in developing countries?
Which of the following is NOT a potential factor contributing to intrauterine growth restriction?
Which of the following is NOT a potential factor contributing to intrauterine growth restriction?
What is a common finding in hemoglobin electrophoresis when diagnosing thalassemia?
What is a common finding in hemoglobin electrophoresis when diagnosing thalassemia?
What is a potential genetic consequence of an individual with alpha thalassemia mating with a partner who is missing a single allele?
What is a potential genetic consequence of an individual with alpha thalassemia mating with a partner who is missing a single allele?
What is the primary management strategy for pregnancies affected by severe alpha or beta thalassemia?
What is the primary management strategy for pregnancies affected by severe alpha or beta thalassemia?
Which of the following statements is TRUE concerning individuals with beta thalassemia major?
Which of the following statements is TRUE concerning individuals with beta thalassemia major?
What is the primary prenatal concern for pregnancies affected by thalassemia?
What is the primary prenatal concern for pregnancies affected by thalassemia?
Why is iron supplementation recommended for pregnant women with thalassemia, even if their red blood cell indices are normal?
Why is iron supplementation recommended for pregnant women with thalassemia, even if their red blood cell indices are normal?
What is the term for a person who inherits both sickle cell trait and beta thalassemia trait?
What is the term for a person who inherits both sickle cell trait and beta thalassemia trait?
What is the most common inheritance pattern for spherocytosis?
What is the most common inheritance pattern for spherocytosis?
What is the recommended screening protocol for G6PD deficiency during pregnancy?
What is the recommended screening protocol for G6PD deficiency during pregnancy?
Which of the following is a prenatal care recommendation for pregnancies with thalassemia?
Which of the following is a prenatal care recommendation for pregnancies with thalassemia?
What is the typical outcome for fetuses affected by alpha thalassemia major?
What is the typical outcome for fetuses affected by alpha thalassemia major?
What is the main reason for recommending midwife consultation for women with G6PD deficiency?
What is the main reason for recommending midwife consultation for women with G6PD deficiency?
Why is genetic counseling recommended for couples with a family history of thalassemia?
Why is genetic counseling recommended for couples with a family history of thalassemia?
How does G6PD deficiency affect red blood cells?
How does G6PD deficiency affect red blood cells?
Which of the following is NOT a characteristic of spherocytosis?
Which of the following is NOT a characteristic of spherocytosis?
What is the typical course of treatment for G6PD deficiency during pregnancy?
What is the typical course of treatment for G6PD deficiency during pregnancy?
Why is it important for midwives to notify pediatric providers about newborns born to mothers with G6PD deficiency?
Why is it important for midwives to notify pediatric providers about newborns born to mothers with G6PD deficiency?
What is the recommended diagnostic procedure for women presenting with unexplained anemia during pregnancy?
What is the recommended diagnostic procedure for women presenting with unexplained anemia during pregnancy?
What is the primary concern for fetal health in women with G6PD deficiency?
What is the primary concern for fetal health in women with G6PD deficiency?
Which of the following is a clinical manifestation of G6PD deficiency?
Which of the following is a clinical manifestation of G6PD deficiency?
What is the primary concern regarding antiphospholipid syndrome during pregnancy?
What is the primary concern regarding antiphospholipid syndrome during pregnancy?
Which of the following is NOT a common clinical manifestation of antiphospholipid syndrome?
Which of the following is NOT a common clinical manifestation of antiphospholipid syndrome?
What is the typical approach to fetal surveillance for women with antiphospholipid syndrome?
What is the typical approach to fetal surveillance for women with antiphospholipid syndrome?
In which scenario is anticoagulation therapy typically RECOMMENDED for women with thrombophilias?
In which scenario is anticoagulation therapy typically RECOMMENDED for women with thrombophilias?
Which of the following statements BEST describes the use of thrombophilia testing?
Which of the following statements BEST describes the use of thrombophilia testing?
Flashcards
RhoD Immunoglobulin
RhoD Immunoglobulin
A medication used to prevent Rh incompatibility in pregnant women with Rh-negative blood.
Timing of Administration
Timing of Administration
RhoD immunoglobulin is typically administered between 26 to 28 weeks of pregnancy.
Indications for Use
Indications for Use
Used during birth or events causing maternal-fetal blood mixing, like trauma or amniocentesis.
Standard Dose
Standard Dose
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Kleinhauer-Betke Test
Kleinhauer-Betke Test
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Autosomal Recessive Inheritance
Autosomal Recessive Inheritance
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Prophylaxis Timing
Prophylaxis Timing
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Normal Hemoglobin Levels
Normal Hemoglobin Levels
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High Hemoglobin Concerns
High Hemoglobin Concerns
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Anemia Effects
Anemia Effects
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Heritable Anemias
Heritable Anemias
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Maternal Deaths & Anemia
Maternal Deaths & Anemia
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Iron Deficiency Anemia
Iron Deficiency Anemia
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Preterm Birth Risk
Preterm Birth Risk
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Fetal Hypoxemia
Fetal Hypoxemia
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Anemia Classification
Anemia Classification
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Antiphospholipid Syndrome
Antiphospholipid Syndrome
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Recurrent Miscarriage
Recurrent Miscarriage
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Thrombophilia
Thrombophilia
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Heparin Therapy
Heparin Therapy
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Fetal Surveillance
Fetal Surveillance
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G6PD Deficiency
G6PD Deficiency
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Oxidant Medications
Oxidant Medications
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X-linked Inheritance
X-linked Inheritance
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Hemolytic Anemia
Hemolytic Anemia
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Spherocytosis
Spherocytosis
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Partner Carrier Testing
Partner Carrier Testing
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Fetal Growth Abnormalities
Fetal Growth Abnormalities
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Pre-existing Conditions
Pre-existing Conditions
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Erythrocyte Membrane Defect
Erythrocyte Membrane Defect
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Clinical Care Guidelines
Clinical Care Guidelines
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Hemoglobin A2
Hemoglobin A2
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Hemoglobin F
Hemoglobin F
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Thalassemia and infertility
Thalassemia and infertility
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Prenatal care in thalassemia
Prenatal care in thalassemia
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Iron supplementation
Iron supplementation
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Folate supplementation
Folate supplementation
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Genetic counseling
Genetic counseling
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Compound inheritance
Compound inheritance
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Alpha major
Alpha major
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Beta thalassemia major
Beta thalassemia major
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Study Notes
Hematologic Disorders in Pregnancy
- Overview: This lecture covers potential hematologic complications in pregnancy, focusing on the antenatal period. Topics include RhD alloimmunization, inherited anemias (like G6PD deficiency, spherocytosis, elliptocytosis, and hemoglobinopathies), and conditions affecting platelets and clotting factors (thrombocytopenia and thrombophilia).
RhD Isoimmunization
- Risk: Exposure to Rh-positive fetal red blood cells in an Rh-negative mother can trigger an immune response, potentially harming the fetus.
- Prevention: Rho(D) immunoglobulin (RhoGAM or Rhophylac) is a blood-based product given routinely to Rh-negative pregnant women at 26-28 weeks gestation to prevent Rh factor isoimmunization. A second dose may be needed after delivery if the baby is Rh-positive. This prophylactic treatment can prevent potentially severe fetal effects.
- Other scenarios: Maternal-fetal blood mixing can occur in other situations, such as: abdominal trauma, amniocentesis, chorionic villus sampling, miscarriages, and terminations. These scenarios also require RhoD immunoglobulin.
Inherited Anemias
- Overview: These are chronic conditions that can affect pregnancy physiology, as physiologic adaptations can exacerbate pre-existing conditions. Often, these are first diagnosed during childhood, but can present during pregnancy.
- G6PD Deficiency: A genetic disorder causing increased risk for hemolytic anemia triggered by certain medications or foods.
- Sickle Cell Disease: Inherited disorder leading to abnormal red blood cell shape, causing various complications, including pain, organ damage, and increased risk for infection. It's imperative to assess for both the pregnancy and the inheritance, as it can affect the baby. Heterozygous (trait) is usually asymptomatic. Homozygous (disease) is typically life-threatening.
- Thalassemia: Genetic disorder characterized by reduced or absent hemoglobin production, resulting in various complications including anemia and high risk for adverse pregnancy outcomes.
Other Hematologic Disorders
- Spherocytosis: Heritable anemia that results in changes to the erythrocyte membrane structure, leading to fragile, spherical red blood cells, often precipitated by severe infection, trauma or pregnancy.
- Elliptocytosis: Heritable anemia with mildly affected red blood cell shape, causing less severe symptoms than spherocytosis.
- Thrombocytopenia: Low platelet count, resulting in bleeding problems.
- Thrombophilia: Increased risk of blood clots.
- Anemia: Low hemoglobin or hematocrit levels which are often associated with other conditions like pregnancy, chronic disease and even genetic conditions. Careful consideration of factors that can affect these measurements (like altitude and race) is important.
Management of pregnancy
- Prenatal Care: Thorough screening, including antibody screens and hematocrit/hemoglobin checks, is important, and can identify potentially problematic conditions early.
- Treatment: Appropriate management for conditions is tailored to the severity, the presence of related maternal or fetal issues, and the stage of pregnancy. Often, consultation with specialists such as neonatologists is necessary for those with severe conditions, especially in the case of homozygous variants.
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