Sunday, February 22, 2015

Rh incompatibility USMLE Step 2 CK doubt

If the patient is sensitized and is making Rh antibody, there is no point giving, Rhogam right?

Nope. It is only for prevention to Rh sensitisation. It's not the treatment.

I see!

So once she is sensitized, nothing can be done?

Nope.

So, say there is a mother who had a kid with hemolytic disease last pregnancy. Will I be giving her Rhogam next pregnancy?

No.

You monitor the Rh antibody levels (by titres using indirect antiglobulin test).

If >1:4 woman is considered sensitized.

If >1:16 do the spectrometric test by using fetal cells taken by amniocentesis (To monitor bilirubin levels!)

Bilirubin low: Repeat amniocentesis in 2-3 weeks.

Bilirubin high: Measure hematocrit of baby using percutaneous umbilical blood sampling.

If the baby is affected (Fetal hematocrit low), only treatment is to give blood transfusion to the baby in utero (Intrauterine transfusion) And delivery at 37 weeks. Or even earlier.

Ooh. I get it all now <3

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