A pregnant woman presented in labor to the ER. She mentions that she, her husban
ID: 97236 • Letter: A
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+
9. Before leaving the hospital, we need to explain to the mother what happened so she can understand that future pregnancies will require extensive pre-natal care.
Does she have Rh+ memory cells in her lymph nodes from her previous pregnancies? ________
Why is Rhogam given? ______________________________________________________________
Why would Rhogam be ineffective now?_________________________________________________
___________________________________________________________________________________
Explanation / Answer
Does she have Rh+ memory cells in her lymph nodes from her previous pregnancies?
Yes, her body had made anti-Rh antibodies following the birth of first baby and it is still intact in the form of memory cells.
Why is Rhogam given?
Rhogam is anti-Rh(D) globulin which prevents the formation of antibodies against Rh antigens in the Rh -ve mother on giving birth to a Rh +ve child.
Why would Rhogam be ineffective now?
Rhogam prevents the formation of antibodies against Rh, but the mother already had given birth to two babies. So she already has these antibodies inside her and thus cant won't be effective now.
- Her future pregnancies will require extra pre-natal care so that her baby can be early diagnosed of erythroblastosis fetalis and hazards can be prevented.
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