Medicine an Surgery notes

Apr 25th, 2015
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Rh ISOIMMUNIZATIONDefinition: Maternal alloimmunization, also known as isoimmunization, occurs when a woman's immune system is sensitized to foreign erythrocyte surface antigens, stimulating the production of immunoglobulin G (IgG) antibodiesGeneral ConsiderationsThe D antigen is a common, strongly immunogenic antigen, 50 times more immunogenic than the other Rh antigens. The prevalence of antibody formation to Rh+ blood depends on the dose of Rh+ cells: 1 mL of cells sensitizes 15% of individuals exposed; 250 mL sensitizes 60-70%.After the initial exposure to Rh+ cells, weak IgM antibody can be detected as early as 4 weeks. This is followed by a rapid conversion to IgG antibody. A second exposure to as little as 0.03 mL of Rh+ erythrocytes may result in the rapid formation of IgG antibodiesA fetus receives half of its genetic components from its mother and half from its father and may therefore have different blood groups than those of its mother. Some blood groups may act as antigens in individuals not possessing those blood groups. The antigens reside on red blood cells. If enough fetal cells leak into the maternal blood, a maternal antibody response may be provoked. Some blood types specifically produce antibodies capable of crossing the placenta. They then enter the fetal circulation and destroy the fetal erythrocytes, causing hemolytic anemia.This leads to responses in the fetus to meet the challenge of enhanced blood cell breakdown. These changes

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