a well-hydrated male infant is 1 day old when the neonatologist observes he is beginning to appear jaundiced. this baby is the first child of a 30-year-old computer analyst with no previous obstetric history or history of prior blood transfusion. the pregnancy had been normal. total bilirubin, hemoglobin/hematocrit, blood type/rh, and direct antiglobulin tests are ordered for the baby. a cord blood sample has not been collected at delivery. blood grouping and rh testing and a screening test for unexpected antibodies are requested for the mother. laboratory data are as follows: neonatal results total bilirubin: 10.8 mg/dl hemoglobin: 16.9 g/dl hematocrit: 52% blood group and rh: a, rh positive direct antiglobulin test: negative maternal results blood group and rh: o, rh negative unexpected antibody screen: negative treatment the baby is immediately started on phototherapy. subsequent total bilirubin tests are no higher than the 24-hour value and continue to decrease over the next 48 hours. at discharge, the total bilirubin is 6.9 mg/dl. Questions 1. the mother is group o rh negative, and the baby is group a rh positive. what are the possible consequences of the differences in blood group and rh status? 2. why was phototherapy selected for the baby as the treatment of choice rather than an exchange transfusion? 3. should the mother receive prophylactic therapy, such as immune globulin d?
a well-hydrated male infant is 1 day old when the neonatologist observes he is beginning to appear jaundiced. this baby is the first child of a 30-year-old computer analyst with no previous obstetric history or history of prior blood transfusion. the pregnancy had been normal. total bilirubin, hemoglobin/hematocrit, blood type/rh, and direct antiglobulin tests are ordered for the baby. a cord blood sample has not been collected at delivery. blood grouping and rh testing and a screening test for unexpected antibodies are requested for the mother. laboratory data are as follows: neonatal results total bilirubin: 10.8 mg/dl hemoglobin: 16.9 g/dl hematocrit: 52% blood group and rh: a, rh positive direct antiglobulin test: negative maternal results blood group and rh: o, rh negative unexpected antibody screen: negative treatment the baby is immediately started on phototherapy. subsequent total bilirubin tests are no higher than the 24-hour value and continue to decrease over the next 48 hours. at discharge, the total bilirubin is 6.9 mg/dl.
Questions
1. the mother is group o rh negative, and the baby is group a rh positive. what are the possible consequences of the differences in blood group and rh status?
2. why was phototherapy selected for the baby as the treatment of choice rather than an exchange transfusion?
3. should the mother receive prophylactic therapy, such as immune globulin d?
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