{"id":452,"count":1,"description":"<style>\r\n  .hrisk-wrap { display: grid; grid-template-columns: 5rem 1fr; gap: 0.75rem 0.1rem; }\r\n  .hrisk-title { grid-column: 1 \/ -1; font-weight: 600; font-size: 1.05rem; margin-bottom: 0.25rem; }\r\n  .hrisk-code { font-weight: 600; white-space: nowrap; }\r\n  .hrisk-text { line-height: 1.5; }\r\n  .hrisk-text ul { margin: .5rem 0 .25rem 1.25rem; }\r\n.hrisk-text ul,\r\n.lrisk-text ul {\r\n  list-style: disc !important;       \/* show bullets *\/\r\n  list-style-position: outside;      \/* normal positioning *\/\r\n  padding-left: 1.25rem;             \/* indent *\/\r\n  margin-left: 0;                    \/* optional *\/\r\n}\r\n<\/style>\r\n\r\n<div class=\"hrisk-wrap\">\r\n  <div class=\"hrisk-title\">Guidance for HDFN prevention and monitoring (High Risk Statements)<\/div>\r\n\r\n  <div class=\"hrisk-code\">H1<\/div>\r\n  <div class=\"hrisk-text\">Communication between the obstetric, neonatal, and transfusion care providers regarding alloimmunized pregnancies is recommended.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H2<\/div>\r\n  <div class=\"hrisk-text\">Once a clinically significant antibody has been identified, paternal antigen testing is suggested to assess the risk to the fetus, if paternity is assured.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H3<\/div>\r\n  <div class=\"hrisk-text\">For anti-K antibodies, early consultation with Maternal Fetal Medicine is recommended.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H4<\/div>\r\n  <div class=\"hrisk-text\">For patients with clinically significant antibodies to RhD, C\/c, E, or K, non-invasive prenatal testing (<em>cffDNA<\/em> testing of maternal plasma) is recommended to determine if the fetus is at risk.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H5<\/div>\r\n  <div class=\"hrisk-text\">Once a clinically significant antibody has been identified, antibody titration is recommended every four weeks until 28 weeks and every two weeks thereafter. If a critical titre is reached, referral to Maternal Fetal Medicine is recommended.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H6<\/div>\r\n  <div class=\"hrisk-text\">Once a critical titre is reached, further monitoring of antibody titres is not routinely recommended; evaluation by Maternal Fetal Medicine with monitoring by MCA Doppler ultrasound is recommended.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H7<\/div>\r\n  <div class=\"hrisk-text\">\r\n    Maternal fetal medicine consultation is recommended for alloimmunized pregnancies with clinically significant antibodies when:\r\n    <ul>\r\n      <li>a critical titre is identified, and the corresponding fetal antigen is unknown or predicted positive based on <em>cffDNA<\/em> assessment.<\/li>\r\n      <li>an anti-K antibody is identified.<\/li>\r\n      <li>a previous fetus or neonate has been affected by HDFN requiring intrauterine or post-natal transfusion and the corresponding fetal antigen is unknown or predicted positive based on <em>cffDNA<\/em> assessment.<\/li>\r\n    <\/ul>\r\n  <\/div>\r\n\r\n  <div class=\"hrisk-code\">H8<\/div>\r\n  <div class=\"hrisk-text\">\r\n    Monitoring of alloimmunized pregnancies with antibody titration is <em>not<\/em> routinely recommended in the following situations:\r\n    <ul>\r\n      <li>a critical titre is identified,<\/li>\r\n      <li><em>cffDNA<\/em> assessment predicts that the fetus is negative for the corresponding antigen,<\/li>\r\n      <li>a previous fetus or neonate was affected by HDFN and required intrauterine or post-natal transfusion.<\/li>\r\n    <\/ul>\r\n  <\/div>\r\n\r\n  <div class=\"hrisk-code\">H9<\/div>\r\n  <div class=\"hrisk-text\">Maternal (or cord) antibody titrations are not recommended immediately pre-delivery, or postpartum.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H10<\/div>\r\n  <div class=\"hrisk-text\">RhIg is recommended for RhD negative pregnancies following any fetal intervention, invasive prenatal testing, or maternal abdominal trauma starting at 8 weeks 0 days gestation.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H11<\/div>\r\n  <div class=\"hrisk-text\">RhIg is recommended for RhD negative pregnancies starting at 8 weeks 0 days gestation, following an ectopic pregnancy.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H12<\/div>\r\n  <div class=\"hrisk-text\">RhIg is recommended for RhD negative pregnancies starting at 8 weeks 0 days gestation, following molar pregnancy.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H13<\/div>\r\n  <div class=\"hrisk-text\">RhIg is recommended for RhD negative pregnancies following amniocentesis.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H14<\/div>\r\n  <div class=\"hrisk-text\">RhIg is recommended for RhD negative pregnancies following chorionic villus sampling.<\/div>\r\n\r\n  <div class=\"hrisk-code\">H15<\/div>\r\n  <div class=\"hrisk-text\">\r\n    When RhIg may have been previously administered and there is uncertainty about whether the antibody detected is passive (due to RhIg) or immune:\r\n    <ul>\r\n      <li>RhIg is recommended for routine antenatal dosing and for sensitizing events.<\/li>\r\n      <li>ongoing titration of anti-D at usual intervals is recommended.<\/li>\r\n      <li>repeat antibody assessment is suggested at six (6) months postpartum.<\/li>\r\n    <\/ul>\r\n  <\/div>\r\n<\/div>","link":"https:\/\/transfusionontario.org\/en\/category\/perinatal\/perinatal-guidance-hdfn-prevention-monitoring\/","name":"Guidance for HDFN prevention and monitoring","slug":"perinatal-guidance-hdfn-prevention-monitoring","taxonomy":"category","parent":448,"meta":[],"acf":[],"_links":{"self":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/categories\/452","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/categories"}],"about":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/taxonomies\/category"}],"up":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/categories\/448"}],"wp:post_type":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/posts?categories=452"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}