006-Rare Antibody Causing Hemolytic Disease of the Fetus & Newborn

Course # DL-006 - RARE ANTIBODY CAUSING HEMOLYTIC DISEASE OF THE FETUS AND NEWBORN

by Anya Atenousazar, CLS, BS

&

by Helen Sowers, M.A. CLS, Dept. of Biological Science (Retired), California State University East Bay

Approved for 1.0 CE
Level of Difficulty: Intermediate

Case Study:

A 22- year-old Hispanic female, gravida 4, para 1-0-2-1* was admitted to Ridgecrest Hospital, Ridgecrest, CA. She had no significant pain, but the tocometer showed that she had contractions. The physician performed a transvaginal ultrasound in order to determine the accurate pregnancy dating. The ultrasound showed that the patient was at 31 weeks and 5 days gestation. Additionally, ultrasound revealed fetal hydrops and anemia characteristic of hemolytic disease of fetus and newborn (HDFN). The doctor ordered some additional prenatal tests to be done on the mother. The test results showed that the HDFN was due to anti–Rh 17 antibody that was being produced by the mother. As a result, intravenous immunoglobin was given to the mother to inactivate maternal antibodies, preventing them from further crossing the placenta and hemolyzing fetal red blood cells. In addition, the patient received Terbutaline and Procardia in order to prevent preterm delivery. The patient’s history indicated that the two previous miscarriages were also due to the same condition. Of further interest was her sister’s having had a miscarriage due to HDFN caused by the same rare antibody. It was decided that the mother be transferred from Ridgecrest Hospital to the Loma Linda University Medical Center (LLUMC) for more advanced care.

Objectives:

At the end of this course the participant will be able to:

  1. Describe the conditions that lead to hemolytic disease of the fetus and newborn (HDFN)
  2. Outline the Fisher-Race nomenclature for the Rh system
  3. Explain the occurrence of the rare antibody causing HDFN in the case study
  4. Describe the treatment used to treat the fetus in the case study
  5. State the problems involved in obtaining blood for transfusing the fetus/infant
  6. Discuss the consequences in the infant of abnormalities in chemistry results

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