Medicine an Surgery notes

Apr 25th, 2015
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Rhesus IsoimmunizationProf. Faheem ZayedRhesus IsoimmunizationProf. Faheem Zayed2009:Blood groups (1900):Antigens: AntibodiesO (45%) AntiA+Anti BA (40%) Anti BB (10%) Anti AAB (5%)A and B : dominantO : recessive:Rhesus factor (1940)Agglutinogen (C,D,E) mainly DC,D,E dominant antigend,e recessive antigenRh positive about 85%( homozygous (DD)(35%), or heterozygous (Dd) (50%)Rh negative about 15%Incidence of Rh -ve in far east is about 1%Examples of Rh factor: (CDe=R1) , (Cde=r)(cDE=R2). Other systems:kell-antikell,luther,Duffy,etcSo in response to introduction of foreign protein(antigen)--- production of antibody to. neutralize the antigenIn ABO and other non Rh-incompatibility: Itusually causes mild anaemia, mainly as. there is no intrapartum boostingIn Rhesus isoimmunization: mainly (D), but C,Ecan produce antibodiesFeto-maternal haemorrhage: during pregnancy leakage of fetal cells in the. maternal circulation {(Rh+ve) fetal cells in Rh-ve maternal circulation}:Examplesspontaneous abortionInduced abortionAPH. E.C.VCordocentesis, CVS, amniocentesissevere preeclampsiaEctopic pregnancyCaesarean sectionManual removal or placenta .Silent feto-maternal hage-Development of Rhesus antibodies: dependson factorsInborn ability to respond- 1protection if ABO incompatible1\10- 2Strength of Rh antigen stimumlus (CDe=R1)- 3Volume of leaking feta blood (0.25ml) - 4IgM (7 days) doesnt cross placenta, then IgG)21 day

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