Describe the different between a direct and indirect combs test.

Question..Mrs waymash was 31 years old when she became pregnant for the third time ,her first born child ,a male was healthy and during her second pregnancy Mrs waymash was noted to have an indirect coombs titre at a 1:16 dilution of her serum.The foetus was followed closely and delivery of a healthy baby induced at 36 weeks gestation.
(1) what is the coombs test? Describe what this test measures and the clinical condition associated with it .
(2) Describe the different between a direct and indirect coombs test?
Five years later Mrs Waymarsh was pregnant again. At 14 weeks of gestation her indirect coombs titre was 1:8 and at 18 weeks it was 1:.6. Amniotic fluid was obtained at 22,24,27,and 29 weeks of gestation and was found to have increasing amount of bilirubin.
(3) WHAT IS THE DIAGNOSISI FOLLOWING THE BILIRUBIN TEST? WHAT TREATMENT WOULD YOU SUGGEST?
(4)WHAT PREENTATIVE MEASURE COULD BE GIVING TO MRS WAYMASH? HOW DOES THIS PREVENTATIVE THERAPHY WORK.
(5)WHAT OTHER BLOOD GROUP ANTIGENS COULD LEAD TO SIMILAR SYMPTOMS AND WHY.
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