37. Which of the following is true for routine antenatal anti-D prophylaxis in D negative pregnant mothers to prevent isoimmunisations ?
[1] 125 IU at 28 and 34 weeks of gestation
[2] 250 IU at 28 and 34 weeks of gestation
[3] 500 IU at 28 and 34 weeks of gestation
[4] 1000 IU at 28 and 34 weeks of gestation
Answer = [3]
All D negative pregnant women who have not been previously sensitised should be offered routine antenatal prophylaxis with anti‐D Ig (RAADP) either with a single dose regimen at around 28 weeks, or two‐dose regimen given at 28 and 34 weeks
(A) Two‐dose regimen = a minimum dose of anti‐D Ig 500 IU is recommended at 28 and 34 weeks.
(B) Single dose regimen = 1500 IU should be administered between 28 and 30 weeks. The single dose regimen may be more cost effective potentially enabling better compliance and providing logistic benefits.
38. Which of the following is not used for estimation of fetomaternal hemorrhage (FMH) ?
[1] Kleihauer test
[2] Liley chart
[3] Flow cytometry based
[4] None of these
39. Which of the following test is used to estimate fetal anemia in Rh isoimmunised pregnancy ?
[1] Amniocentesis and Liley Chart
[2] Middle cerebral artery flow
[3] Both of these
[4] None of the mentioned methods
Answer 38 = [2]
Answer 39 = [3]
Kleihauer test is based on resistance of fetal Hb to alkali or acid denaturation as compared to adult Hb and is used to estimate fetal blood in maternal circulation ie it estimates FMH. This can also be done using flow cytometry method.
However Liley chart is used to estimate amount of fetal anemia in already isoimmunised pregnancy. Note that it needs repeated amniocentesis. Non invasive method for estimation of fetal anemia is by peak systolic velocity of middle cerebral artery.