Definitions Instructions Sources Key words/Abbreviations Look for designation in maternal s. Blood Group 1st Prenatal Care Record under Check box yes or no record of: Problem list or—initial risk assessment Mark only if a mother has a Isoimmunization Maternal antibody formation Complications positive antibody screen not due Allo-immunization that may lead to fetal red to Rh immunoglobulin (Rhogam Rh isoimmunization blood cell destruction and fetal 2nd Labor and Delivery Nursing or Rhophylac). Do not mark as Anti-D alloimmunization anemia Admission Triage Form positive in a mother recently given Atypical antibody under Rh immunoglobulin . ammoimmunization Admission chief Anti-Kell antibodies complaint Anti-Duffy antibodies Comments Anti-Kidd antibodies Medications Anti-E antibodies Anti-C antibodies 3rd Admission H&P under Hemolytic disease of fetus Admission chief caused by maternal complaint antibodies Current pregnancy history Fetal anemia caused by Problem list/findings maternal antibodies Past medical history MOC Doppler Ultrasound 4th Delivery Record under immune hydrops Maternal OB/labor summary Labor and delivery admission history Labor summary record 14. Risk factors in this pregnancy
Definitions Instructions Sources Key words/Abbreviations s. Blood Group Maternal antibody formation that may lead to fetal red blood cell destruction and fetal anemia Check box yes or no Mark only if a mother has a positive antibody screen not due to Rh immunoglobulin (Rhogam or Rhophylac). Do not mark as positive in a mother recently given Rh immunoglobulin . 1st Prenatal Care Record under Problem list or—initial risk assessment Complications 2nd Labor and Delivery Nursing Admission Triage Form under Admission chief complaint Comments Medications 3rd Admission H&P under Admission chief complaint Current pregnancy history Problem list/findings Past medical history 4th Delivery Record under Maternal OB/labor summary Labor and delivery admission history Labor summary record Look for designation in maternal record of: Isoimmunization Allo-immunization Rh isoimmunization Anti-D alloimmunization Atypical antibody ammoimmunization Anti-Kell antibodies Anti-Duffy antibodies Anti-Kidd antibodies Anti-E antibodies Anti-C antibodies Hemolytic disease of fetus caused by maternal antibodies Fetal anemia caused by maternal antibodies MOC Doppler Ultrasound immune hydrops 14. Risk factors in this pregnancy
Guide_MPM_BC_Facility_Worksheet_Guidelines.10.14.docx