CHAPTER 15: Fetal Disorders

Fetal Disorders

Which of the following does not contribute to the low rate of alloimmunization in pregnancy?

a. Maternal-fetal ABO incompatibility

b. Administration of anti-D immune globulin

c. Low prevalence of incompatible red cell antigens

d. Consistent maternal immune response to the antigen

d Red Cell Alloimmunization

A 28-year-old G2P1 presents for prenatal care at 10 weeks’ gestation. A type and screen is sent as part of her initial prenatal care labs, and it returns positive for anti-E antibodies at 1:8. What is the best first step in management?

a. Obtain paternal antigen testing

b. Repeat antibody titer in 4 weeks

c. Obtain paternal antibody testing

d. Obtain middle cerebral artery Doppler studies

a Management of the Alloimmunized Pregnancy

A 28-year-old G2P1 presents for prenatal care at 10 weeks’ gestation. A type and screen is sent as part of her initial prenatal care labs, and it returns positive for anti-E antibodies at 1:8. Paternal testing is not an option. The lab reports a critical titer of 1:16. What is the best next step in evaluation?

a. Repeat antibody titer in 4 weeks

b. Amniocentesis for fetal genotype

c. Amniocentesis for fetal phenotype

d. Serial middle cerebral artery Doppler studies starting at 16-18 weeks’ gestation

a Management of the Alloimmunized Pregnancy

A 28-year-old G2P1 presents for prenatal care at 10 weeks’ gestation. A type and screen is sent as part of her initial prenatal care labs, and it returns positive for anti-E antibodies at 1:8. Paternal testing is not an option. The lab reports a critical titer of 1:16. At what antibody titer would you recommend initiation of screening for fetal anemia with middle cerebral artery Doppler studies?

a. 1:8

b. 1:16

c. 1:32

d. 1:64

c Red Cell Alloimmunization

A 36-year-old G3P2 at 28 weeks’ gestation presents as a referral for sonographic abnormalities. On ultrasound fetal pleural effusions, skin edema, and polyhydramnios are noted, as shown below. Which of ...