ISOIMMUNISATION.

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Rh ISOIMMUNIZATION Ghadeer Al-Shaikh, MD, FRCSC

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Presentation transcript:

ISOIMMUNISATION

DEFINITION Isoimmunisation is defined as production of immune antibodies in an individual in response to an antigen derived from another individual of the same species provided,the first one lacks the antigen

stages Sensitisation Immunisation

types Rh incompatibility ABO incompatibility

Definition – rh incompatibility Rh incompatibility is a condition that develops when a pregnant woman has Rh negative blood and the baby in her womb has Rh positive blood

incidence Indians 1%

Aetiology Transfusion of Rh positive blood to an Rh negative women Fetomaternal leak

Pathophysiology

Fetal effects Anemia Icterus gravis Erythroblastosis fetalis Hydrops fetalis

Hydrops fetalis

Prenatal assessment and management Blood test to determine blood type and Rh factor at initial visit Indirect coomb’s test for Rh negative women Negative Rh(D)immunoglobulin at 28 weeks Rh(D)immunoglobulin after birth

Contd…………. Indirect coomb’s test for Rh negative women Positive Repeat test to see any rise in antibody titer

Postpartum management Direct coomb’s test Rh(D) immunoglobulin, IM ,72 hours after delivery

Abo incompatability ABO incompatability occurs when the mothers blood type is O and the fetus blood type A,B,or AB

PATHOPHYSIOLOGY O blood group Develop anti-A and anti-B antibodies in response to antigen Antibodies may be either IgG or IgM IgG antibodies cross the placenta barrier Hemolysis of red blood cells