Rh Incompatibility
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-What is Rh factor?
- Rh isoimmunisation?
-can be prevented or not?
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A baby's Rh status is determined from the mother and father. If the mother is Rh negative and
the father is Rh positive, the baby has at least a 50% chance of being Rh positive
The baby's blood may come into contact with the mother's blood flow during:
Miscarriage
Induced abortion
Ectopic pregnancy
Trauma during pregnancy
Amniocentesis or other invasive testing procedures related to pregnancy—rare
Rarely affect first pregnancy but could affect future pregnancy
A woman can also become sensitized to Rh-positive blood if she receives an incompatible
blood transfusion.
[Link] Factors
Factors that put you at risk for Rh incompatibility include being an Rh-negative pregnant
woman who:
Had a prior pregnancy with a baby that was Rh positive
Had a prior blood transfusion or amniocentesis
Did not receive Rh immunization prophylaxis during a prior pregnancy with an Rh-
positive baby
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.Swelling of the body, which may be associated with heart failure or respiratory
problems.
Jaundice
Anemia
A complication of untreated jaundice is kernicterus, a syndrome which can affect the baby's
nervous system.
Contact your doctor right away if your baby:
Has a yellow or orange appearance to the skin
Does not sleep
Is hard to wake up
Is not breastfeeding or has difficulty sucking from a bottle
Is restless or fussy
Call for emergency medical help if your baby has:
High pitched crying or crying that won't stop
A bowed body
A stiff, limp, or floppy body
Strange eye movements
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You cannot detect Rh incompatibility on your own. A blood test can determine whether you
are Rh positive or Rh negative. The blood test will also look for Rh antibodies or monitor the
levels of antibodies through pregnancy. If the antibody levels are high, an amniocentesis can
determine if the fetus is ill.
It is important to have a blood test at the beginning of pregnancy.
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Rh incompatibility is almost completely preventable using immunization. The best treatment
is prevention.
If Rh incompatibility does occur, then the baby may need treatment based on symptoms such
as:
Full recovery is expected for mild Rh incompatibility. Treatment may include:
Aggressive hydration
Phototherapy —light therapy to treat skin conditions
Both hydrops fetalis and kernicterus are more severe conditions and treated with intrauterine
fetal transfusion. Long-term problems can also develop with severe cases, including:
Cognitive delays
Movement disorders
Hearing loss
Seizures
Prevention
RhoGAM- 1st injection- at 28wk of pregnancy
2nd injection- within 72 hrs after delivery
(. These injections will block the mother's body from developing antibodies)
Women at risk may also be given these injections after a miscarriage, induced abortion, or
ectopic pregnancy. These injections will protect the current pregnancy and future
pregnancies.
Rh Incompatibilty (Another discussion)
What does "Rh-negative" mean? —
"Rh" is the name of a protein that can be found on red blood cells.
People who have this protein have an "Rh-positive" blood type.
People who do not have this protein have an "Rh-negative" blood
type. Having an Rh-positive or Rh-negative blood type does not affect
your health. But problems can happen during pregnancy if a woman
has Rh-negative blood and her baby has Rh-positive blood.
Luckily, there is a medicine that can prevent these problems most of
the time.
Women with Rh-positive blood do not have the problems
How do I know my blood type? — Your doctor will do blood tests at
your first prenatal visit. This includes a test to check your blood type.
What problems can happen when a woman has Rh-negative blood?
— Certain problems can happen when a woman has Rh-negative
blood and the baby in her uterus (womb) has Rh-positive blood
Usually, during pregnancy, blood between the mother and baby does
not mix. But sometimes it does, especially right after the baby is
born. If a small amount of the baby's blood gets into the mother's
blood vessels during delivery, the mother's immune (infection-
fighting) system makes proteins called "antibodies." In the woman's
next pregnancy, these antibodies can cross the placenta and damage
some of the next baby's red blood cells. This can cause a condition
called anemia, which is when a person has too few red blood cells. If
this happens, the baby can make more red blood cells, but
sometimes not enough to prevent anemia.
How do I know my baby's blood type? — Sometimes it's hard to
know. If you know your baby's father's blood type, you might know
your baby's blood type. If both you and the baby's father have Rh-
negative blood, your baby will have Rh-negative blood.
If your baby's father has Rh-positive blood, your baby could have Rh-
negative or Rh-positive blood. But if you have Rh-negative blood, the
doctor or midwife will treat your baby as if he or she has Rh-positive
blood. That way, any possible problems can be prevented.
It is also possible to figure out the baby's Rh blood type by doing a
test on the mother's blood. But this test is not done everywhere, and
your insurance might not cover it.
What happens next? — If you are Rh-negative, your doctor or
midwife will do blood tests during pregnancy to check whether you
have antibodies in your blood.
If you do not have antibodies in your blood and your baby is (or
could be) Rh-positive, your doctor or midwife will give you medicine.
This medicine prevents your body from making antibodies that could
attack your baby's red blood cells. This can prevent anemia or other
problems.
The medicine is called anti-D immune globulin (sample brand name:
RhoGAM). It usually comes as a shot. You will get it during your third
trimester.
After your baby is born, the doctor will do a blood test to check your
baby's blood type. If your baby is Rh-positive, your doctor will give
you another dose of anti-D immune globulin soon after delivery. If
your baby is Rh-negative, you do not need another dose.
Women who are Rh-negative might also get anti-D immune globulin
at other times. Doctors give this medicine to Rh-negative women if
they:
●Bleed during pregnancy
●Have a test during pregnancy called amniocentesis or chorionic
villus sampling (CVS)
●Have a miscarriage, which is when a pregnancy ends on its own
●Have an abortion, which is when a woman ends a pregnancy
●Have an ectopic pregnancy, which is a pregnancy that grows in the
wrong place in a woman's body
What happens if I already have antibodies in my blood? — If you
already have antibodies in your blood, anti-D immune globulin will
not help. Your doctor will not give you this medicine.
But he or she will do different tests to monitor your baby during
pregnancy. If anemia or other problems happen, he or she will talk
with you about possible treatments.
What if I get pregnant again? — If you get pregnant again, you will
need treatment again. Rh-negative women are treated with anti-D
immune globulin during each pregnancy, as long as they don't have
antibodies in their blood.