Competency information
Details
Interpret and report results in the correct clinical context.
Considerations
- Practical application of national guidelines for antenatal testing and anti-D prophylaxis (e.g. BCSH, NICE).
- The management of potentially sensitising events during pregnancy.
- Factors affecting the severity of HDFN:
- stage when antibody first detected
- previous history of HDFN
- antibody specificity
- antibody class and subclass
- antibody concentration.
- Mode of action in causing HDFN and antenatal testing requirements if detected in a maternal sample:
- anti-D
- anti-c
- anti-K
- ABO antibodies
- other clinically significant red cell antibodies.
- Role of anti-D in perinatal mortality and morbidity and the risk of anti-D sensitisation.
- Anti-D immunoglobulin:
- how it works
- dosage
- timing of administration for RAADP, in response to a potentially sensitising event (PSE) and post delivery.
- Role of feto-maternal haemorrhage in sensitisation of the mother and how to measure and manage sensitising events.
- What to do if anti-D prophylaxis is ’missed’.
- Advice given to women whose pregnancies are at risk from anti-D.
- Reasons for estimating the size of FMHs.
- Use and limitations of the acid-elution technique to determine FMHs.
- Flow cytometry technique to determine FMHs and its limitations.
- Prophylactic anti-D estimation of dose.
- Problems encountered by the inability to distinguish between immune and prophylactic anti-D.
- Identification of what constitutes a PSE in the first, second and third trimesters of pregnancy.
- Consideration of different RAADP programmes – one-dose vs two-dose.
Relevant learning outcomes
# | Outcome |
---|---|
# 4 | Outcome Use algorithms for routine and non-routine antenatal testing and the use of anti-D prophylaxis and fetomaternal haemorrhage (FMH) testing. |