1. Review of Blood type and Rh

2. Blood types and Blood groups  Blood Types- two parts the ABO part and the Rh part. A, B, O specify the types of proteins found on RBC’s. Rh factor is most important factor in Rh disease  Rh factor group of proteins that occur only on the surface of RBC’s.  Rh factor present on RBC’s then you are Rh positive  Rh factor absent on RBC’s then you are Rh neg. Here’s a link that reviews blood typinglink

3. Rh isoimmunization  Rh isoimmunization occurs when an Rh negative mother has an Rh positive child causes the destruction of the infant’s red blood cells (anemia) during pregnancy and after birth

4. Rh disease  What happens The immune system recognizes foreign cells (rh positive cells that have transferred from fetus to mother through the placenta) and sets out to destroy the invading cells by forming antibodies to recognize future foreign cells to fight off invasion. Antibodies are produced after the first delivery so first baby is unaffected.  Future pregnancies are at risk b/c the body recognizes a fetus with positive blood type as a foreign invasion and the immune response will destroy fetal blood cells. (causing fetal anemia and increase risk for fetal death)

5. Rh isoimmunization Prevention  Mother given anti Rh gamma globulin (RhoGAM) at 28 weeks gestation and within 72 hours after delivery, miscarriage, ectopic and for abortions. Prevents the formation of antibodies that might affect future infants.  **RhoGAM only affective if mother has not already developed antibodies to rh positive blood type.

6. Care Plan for Hemolytic Disease Severity Zone 1 Zone II Upper Zone II Zone III mildmoderate moderate to severe severe Management amnio for delta-OD 450 every 4-5 weeks amnio for delta-OD 450 every 1-2 weeks fetal blood transfusion Delivery at term 37 weeks 34-36 weeks if fetal lungs are mature deliver at once if fetal lungs are mature