Alloimmunization Prevention & Management

An Ounce of Prevention...

100

This is the timeframe after delivery should a women receive Rhogam

What is within 72 hours?

200

This is the name of the quantitative screening test to see how many doses of Rhogam is needed

What is Kleihauer-Betke test?

300

This is the amount of max fetal-maternal hemorrhage that a standard 300mcg dose of anti-D immune globulin covers

What is 30 mL?

400

This is the name of the qualitative screening test to see if Rhogam is needed

What is a rosette assay?

500

This is the dose of Rhogam recommended for Rh neg women undergoing invasive diagnostic testing before 12 weeks

What is 50-120mcg?

...A pound of Cure

100

This is what is done when the mother is Rh neg and it is well-established the father is also Rh neg

What is NADA?

200

This is the critical titer that is associated with severe erythroblastosis fetalis and hydrops?

What is >1:8?

(If 1:8 or less, can follow titers every 4 weeks)

300

Which Duffy antibody subtype can be associated with severe fetal anemia?

What is Fy^a ?

400

This is antibody titer is not well-correlated with fetal status

What is Kell antibody?

500

This is the soonest GA recommended for early delivery of a women with severe fetal anemia due to alloimmunization

What is 32 weeks?

(last fetal transfusion 30-32 weeks. Delivery 32-34 weeks once steroid complete for fetal lung maturity)

Fun Facts

100

This is the smallest amount of fetal-maternal hemorrhage that is known to trigger alloimmunization

What is 0.1mL?

200

This is the percentage that an Rh neg women could become alloimmunized from her Rh positive fetus after an ECV

What is 2-6%

300

This is the median half-life of Rhogam in third trimester

What is 23 days?

400

This surveillance technique is what we used to use prior to the validation of Middle cerebral artery Dopplers for fetal anemia monitoring

What is measuring amniotic fluid bilirubin levels?

500

This is the sensitivity rate for when peak systolic velocity of fetal MCA dopplers measure 1.5x the median for gestational age in predicting moderate or severe fetal anemia

What is 100%?!

(false positive rate is 12%)

To Give or Not to Give

100

This is what you do after you perform a D&C on a molar pregnancy on an Rh neg woman

What is GIVE RHOGAM?

200

This is what you do after an Rh negative mom has a medical abortion

What is GIVE Rhogam?

300

This is what you do for a postpartum Rh negative woman undergoing sterilization

What is STILL GIVE RHOGAM?

(Not only could they still become pregnant again, but alloimmunization complicated blood cross-matching in the future should she ever need blood.)

400

This is what you do post-partum if the Rhogam dose was administered within 3 weeks

What is DON'T GIVE RHOGAM?

500

This is what you do postpartum if it's been >12 weeks after the Rh neg woman has received Rhogam

What is DO NOT GIVE RHOGAM until you've verified the baby is Rh +?