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Isoimmunization occurs when the maternal immune system is sensitized to red blood cell surface antigens. The most common causes of isoimmunization are blood transfusion, and fetal-maternal hemorrhage. [16] The hemolytic process can result in anemia, hyperbilirubinemia, neonatal thrombocytopenia, and neonatal neutropenia. [5]
The term "Rh Disease" is commonly used to refer to HDFN due to anti-D antibodies, and prior to the discovery of anti-Rh o (D) immune globulin, it was the most common type of HDFN. The disease ranges from mild to severe, and occurs in the second or subsequent pregnancies of Rh-D negative women when the biologic father is Rh-D positive.
Anti-Kell 1 is becoming relatively more important as prevention of Rh disease is also becoming more effective. Hemolytic disease of the newborn (anti-Kell 1) is caused by a mismatch between the Kell antigens of the mother and fetus. About 91% of the population are Kell 1 negative and about 9% are Kell 1 positive.
Isoimmunization occurs when the maternal immune system is sensitized to red blood cell surface antigens. The most common causes of isoimmunization are blood transfusion, and fetal-maternal hemorrhage. [13] The hemolytic process can result in anemia, hyperbilirubinemia, neonatal thrombocytopenia, and neonatal neutropenia. [7]
This is a major cause of HDN, because 75% of pregnancies result in some contact between fetal and maternal blood, and 15–50% of pregnancies have hemorrhages with the potential for immune sensitization. The amount of fetal blood needed to cause maternal sensitization depends on the individual's immune system and ranges from 0.1 mL to 30 mL. [5]
In some cases, the direct Coombs will be negative but severe, even fatal HDN can occur. [15] An indirect Coombs needs to be run in cases of anti-C, [16] anti-c, [16] or anti-M presence. In case of anti-M detection, it is also recommended to perform antigen testing to rule out the presence of HDN. [17]
Generally, diseases outlined within the ICD-10 codes O00-O99 within Chapter XV: Pregnancy, childbirth and the puerperium should be included in this category. v t
With a negative KB test, posttrauma electronic fetal monitoring duration may be limited safely. With a positive KB test, the significant risk of pre-term labour mandates detailed monitoring. KB testing has important advantages to all maternal trauma victims, regardless of Rh status. [7]