A pregnant woman presented in labor to the ER. She mentions that she, her husban

Question

A pregnant woman presented in labor to the ER. She mentions that she, her husband and 2 kids have been on the road for several months following the Grateful Dead Band (yep, that has been a long time now) and any other band, so it is unlikely she has had much pre-natal care. She assures you she always has had an easy time of it, but the second child did seem more tired than the first, although he is 2 years old and fine now. After delivery, the infant appears quite jaundiced and has the following blood values: (use appendix F in the back of the book or the internet to determine if these are normal or abnormal). Hematocrit: 28% Bilirubin 18 mg/dl AST 30 U/ml Direct Coombs test positive Infant type A+

4. What does a “Direct Coombs test” show if it is positive, as it is here? ______________________

5. Why do you think the number of RBCs is low? _________________________________________

6. Whose antibodies are causing this reaction? ___________What are the antibodies against? ______

Explanation / Answer

4. What does a “Direct Coombs test” show if it is positive, as it is here?

Direct Coombs test positive means blood contains antibodies which fight against red blood cells (RBC).

This happens when a incompatible transfusion blood occurred or may be related to conditions haemolytic disease of the newborn (HDN).

.5. Why do you think the number of RBCs is low?

RBA count is low because the baby is suffering from anaemia.

6. Whose antibodies are causing this reaction? ___________What are the antibodies against?

Mother’s antibody is causing the problem. Here the blood group of baby and mother are different. Thus for mother’s antibody babies blood is a foreign object.

Antibodies are against the babies RBC.

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