Jual obat aborsi asli solo WA-081222292216 bergaransi tuntas bersih

⭐⭐⭐PESAN PRODUK ASLI ⭐⭐⭐
0812 - 2229 - 2216

JUAL OBAT ABORSI CYTOTEC 0812 2229 2216 OBAT ABORSI 1 2 3 4 5 6 BULAN 100% AMPUH | OBAT CYTOTEC MISOPROSTOL | OBAT PENGGUGUR KANDUNGAN | OBAT PENDORONG JANIN | OBAT PELANCAR HAID | OBAT TELAT BULAN ASLI | OBAT ABORSI ALAMI CARA PALING AMAN UNTUK MENUNDA ATAU MENGGUGURKAN KEHAMILAN.

Jual Obat Aborsi WA 081222292216 Obat Penggugur Kandungan Asli Obat Aborsi Cytotec & Gastrul Asli 100% Manjur Dan Aman. Obat Penggugur Kandungan, Obat Aborsi, Harga Obat Aborsi, WA 081222292216 | Jual Obat Aborsi Usia 1 Bulan, Jual Obat Aborsi Usia 2 Bulan, Jual Obat Aborsi Usia 3 Bulan, Jual Obat Aborsi Usia 4 Bulan, Jual Obat Aborsi Usia 5 Bulan, Jual Obat Aborsi Usia 6 Bulan, Cytotec Asli, Pil Cytotec, Pil Aborsi Ampuh, Obat Menggugurkan Kandungan, Obat Menghilangkan Janin, Obat Gastrul Asli, Obat Penggugur Kandungan Asli, Obat Penggugur Kandungan Usia 1-7 Bulan, Obat Telat Bulan, Obat Telat Haid, Obat Aborsi Ampuh, Obat Aborsi Cytotec, Obat Aborsi Asli, Obat Cytotec Asli. Obat Aborsi dengan obat-obatan Menggugurkan kandungan yang bisa dilakukan dengan menggunakan pil aborsi. Jika obat-obatan yang digunakan memang terjamin keasliannya dan Anda mendapatkan dari sumber terpercaya, pengobatan aborsi merupakan pilihan aman bagi kehamilan sampai 20 minggu. Ada dua cara menghentikan kehamilan dengan obat-obatan.Misoprostol atau Cytotec sajaPerempuan juga bisa menggunakan hanya Misoprostol untuk menggugurkan kandungan. Tentu saja dosnya berbeda jika dibandingkan dengan kombinasi Mifepristone dan Misoprostol. Tingkat keberhasilannya bisa mencapai 99%. Lalu, apa itu cytotec? Cytotec adalah nama merek dagang dari Misoprostol. Nama lain yang mungkin sering disebut di Indonesia adalah gastrul, misotab, dan chromelux. Pahami Bahaya Penggunaan Obat Aborsi Tanpa Pengawasan Dokter Saat ini banyak produk obat aborsi yang dijual “gelap” atau tanpa resep dokter. Perlu diketahui, obat tersebut bukan obat yang diracik khusus untuk menggugurkan kandungan. Misoprostol misalnya, sebenarnya diproduksi untuk mengobati penyakit lambung. Namun, obat tersebut diketahui memicu kontraksi dan meluruhkan dinding rahim. Kondisi ini bisa berefek pada gugurnya janin jika dikonsumsi oleh ibu hamil. Aborsi yang dilakukan dengan obat misoprostol biasanya digunakan saat usia kehamilan di bawah 25 minggu atau 6 bulan. Pada beberapa kasus, misoprostol digunakan secara bersamaan dengan obat lain, seperti mifepristone. Namun, mifepristone cenderung sulit didapat dan harganya jauh lebih mahal daripada misoprostol, sehingga banyak orang yang menggunakan misoprostol saja. Lalu, apakah berbahaya mengonsumsi obat aborsi tanpa pengawasan dokter? Tentu saja sudah. Sebab, hanya dokter dan tenaga kesehatan yang dapat menentukan apakah obat-obatan tersebut aman dikonsumsi. Selain itu, saran yang dibutuhkan dari dokter terkait dengan apa yang harus digunakan, aturan penggunaan, dan obat-obatan lain yang harus digunakan untuk meringankan gejala yang muncul ak

1. ISO IMMUNIZATION
DISEASE, ABO AND Rh
INCOMPATIBILITY
Prepared by ,
Ms. Sapna Pal
Lecturer
Government College of Nursing, Kanpur

2. BASICS OF BLOOD
Blood
compose
Plasma (55%) Cell (45%)
Albumin Erythrocytes
Globulin Platelets
Clotting factor Leukocytes

3. Blood Group
Rhesus system

4. ABO system

5. Term Meaning
IgA Found in body secretion like breast milk and saliva and prevent antigen
crossing epithelial membranes and invading deeper tissues.
IgD This is made by B-cells and displayed on their surface. Antigens bind
here to activate B-cells.
IgE Found on cell membrane of basophilisand mast cells and if it binds its
antigen, activates the inflammatory response. This antibody is often
found in excess in allergy.
IgG This is the largest and most common antibody type. It attacks many
different pathogens and crosses the placenta to protect fetus
IgM Produce in large quantities in the primary response and is potent
activator of complement
Primary
response
Antigen encountered for the first time, primary response follows, in
which low level of antibodies can be detected in the blood after 2
weeks.
Secondary
response
Second encounter to antigen produce a secondary response
characterized by rapid memory B-cell response, resulting in a marked
increase in antibody production.

6. Rh incompatibility
•Rh incompatibility occurs when a
woman with an Rh-negative blood type
is exposed to Rh+ positive blood cells,
leading to the development of Rh
antibodies

7. Pathogenesis Of Rh Iso-immunisation
Rh Negative Women
Man Rh positive (Homo/Hetero)
 
Fetus 
Rh NegFetus
No problem
Rh positive Fetus

Rh+veR.B.C.s enter
Maternal circulation

Mother previously sensitized
Secondary immune response

? Iso-antibody (IgG)

Non sensitized Mother
Primary immune response

Fetus unaffected, 1
st
Baby usually escapes.
Mother gets sensitised? 

Fetus
Haemolysis

 ?

9. ABO incompatibility
•Haemolysis associated with ABO
incompatibility exclusively occurs in type
O mothers with fetuses who have type A
or type B blood although it has rarely been
documented in type A mothers with type
B infants with a high titer of anti B IgG.

10. •Type O mother have a high titer of the
antibodies of IgG class against both type
A and type B they cross the placenta and
cause haemolysis in the fetus.

11. Situation where incompatibility may
happen between the blood types of the
mother and the infant
Mother’s
blood type
O A B
Infant’s
blood type
A or B B A

12. Comparison of Rh and ABO incompatibility
Characteristics Rh ABO
Clinical aspects First born
Later pregnancy
Stillborn/hydrops
Severe anemia
Jaundice
Late anemia
5%
More sever
Frequent
Frequent
Moderate to
severe, frequent
Frequent
50%
No increased
severity
Rare
Rare
Mild
Rare
Laboratory
findings
Direct antibody
test
Indirect comb
test
Spherocytosis
Positive
Positive
Rare
Weakly positive
Usually positive
Frequent

13. Antenatal investigation protocol of
Rh negative mothers
•During first antenatal visit blood investigation for Rh and
ABO grouping
•Collect obstetric history
•In case of Rh negative women IgG antibody is detected by
indirect coomb’s test.
•If test found negative at 12
th
week, repeat test at 28
th
and 36
th
week in primigravida. In multigravida test repeat monthly up
to 24 weeks and every 2 weeks thereafter.
•Fetal Rh status: amniotic fluid or chorionic villi to detect fetal
blood group.

15. •Quantitative estimation of IgG antibody at
weekly interval.
-Sudden rise in titer from 1:8 to 1:256 is
very much suggestive of fetal affection.
-Antibody in maternal serum <4IU/Ml is safe
-Antibody in maternal serum >4IU/Ml but
<15 IU/mL is Moderate risk
-If anti D antibody is >15 IU/Ml is severe
HDFN
•Doppler ultrasound to assess fetal anemia.

16. Plan for delivery
•UNIMMUNIZED MOTHERs
No detectable antibody found during
pregnancy, an expectant attitude is
followed till term. Tendency of
pregnancy to overrun expected date
should not be allowed.

17. •IMMUNIZED MOTHERS
If there is evidence of hemolytic process in the fetus
in utero, the patient should be shifted to an equipped
center specialized to deal with Rh problems.
-Mild affection
-Severe affection

18. •Amniotomy (AROM)
•Careful fetal monitoring
•during 2
nd
stage should withheld
•Gentle handle of uterus in 3
rd
stage
•Take care of PPH

19. •Cesarean section in case of prematurity.
-Avoid spillage of blood into peritoneal
cavity
-Routine manual removal of placenta
should be withheld.

20. •Clamp cord
•Collect cord blood for investigation

21. Condition arise in fetus
•Hydrops fetalis
•Icterus gravis neonatrum
•Congenital anemia of the
newborn

22. Pathology Of Iso-immunisation
HAEMOLYSIS  IN UTEROAFTER BIRTH
BILLIRUBIN

ANAEMIA



HEPATIC
ERYTHROPOESIS
& DYSFUNCTION

PORTAL & UMBILICAL VEIN
HYPERTNSION, HEART FAILURE






BIRTH OF AN AFFECTED INFANT -Wide spectrum of presentations. Rapid
deterioration of the infant after birth.May continue for few days to few months.
Chance of delayed anemia at 6-8 weeks probably due to persistence of anti Rh
antibodies.

Jaundice
Kernicterus
Hepatic Failure

DEATH
ERYTHROBLASTOSIS
FETALIS



IUD








23. After delivery
•Anti D administered within 72 hr or
preferably earlier following delivery or
abortion.
•In some case when specified time is
over (>72 hr), she may given up to 14-
28 days after delivery to avoid
sensitization.
•Anti D administered IM to mother 300
µg following delivery.

24. •Rh negative unsensitized woman
should receive 50 µg of Rh immune
globulin within 72 hr of induced or
spontaneous abortion, ectopic or
molar pregnancy or CVS in first
trimester.

25. SUMMARY
We discussed in class about basics of
blood, blood grouping system, ABO
compatibility and pathogenesis of in-
compatibility, protocol followed during
pregnancy, delivery and after delivery.

26. CONCLUSION
•ABO incompatibility has becomea more
significant cause ofhemolytic disease of
the fetus and newbornsince the
introduction of effective anti-D prophylaxis.
•The condition is common and, if clinically
significant at all, causes only mild
jaundice, which can be treated with
phototherapy (PT)

27. Thank you