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Old 09-28-2012
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Immunology Erythroblastosis fetalis and Rh D

Erythroblastosis fetalis happens when maternal IgG anti-RhD antibodies crosses the placenta and causes fetal hemolysis. This happens because previous sensitization to RhD antigens occured in a previous Rh positive pregnancy, generating memory B cells.

I read in Kaplan immunology that memory B cells are not really actively producing antibodies and would have to be reactivated by subsequent exposure to antigens. But how can they be reactivated to produce antibodies if the fetal RBC's (and RhD) do not cross the placenta? Does this mean that memory B cells can cross the placenta? Another possible explanation is that RhD antigens could cross the placenta at 28 wks (since we also administer RhoGam during this period).
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Old 09-28-2012
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placental bleeds often occur with very minor trauma to the gravid uterus.there will be no visible signs but fetal blood will mix with maternal blood and sensitize the memory B cells.
the sensitized IgG crosses the placenta and cause severe fetal hemolysis.
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Last edited by chux; 09-28-2012 at 04:02 PM.
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Old 09-29-2012
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Thanks chux!

I apologize to the grammar Nazis for the OP.
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