Like blood group, the Rh type is also inherited from parents.
Majority of the people are Rh-positive. This is denoted with a plus sign after writing the blood group. For example, AB+ and O+ positive would indicate that the person is Rh-positive.
Similarly, the lack of Rh protein would be indicated with a minus sign after the blood group, like AB- or O-.
During pregnancy, Rh incompatibility can be an issue.
Problems arise when both the partners are not Rh-negative. In that case, there are chances that the baby’s Rh factor may be different from the mother’s.
If the pregnant woman is Rh-negative and her baby is Rh-positive, then the mother’s body would see the Rh-positive protein as a foreign element. So if blood cells from the baby enter the mother’s bloodstream (can happen during pregnancy, labour, and delivery), the mother’s immune system would start making antibodies against the baby’s red blood cells.
The mother’s body is considered sensitized to the baby once her body has made the antibodies, implying that the mother’s body might send antibodies to fight off the baby’s red blood cells.
It takes time for the mother’s body to develop antibodies, so the firstborn children are usually not affected. However, if a mother has become sensitized because of a miscarriage or abortion or during any prenatal testing (amniocentesis, for instance, doctors use a needle to remove some of the fluid from the sac around the baby), her later births may be affected by Rh incompatibility.
With the RBCs in the baby being destroyed, the baby may develop the haemolytic disease. Bilirubin, a chemical that is created by the breakdown of red blood cells, would build up in the baby’s bloodstream.
Rh incompatibility will be detected through blood tests, through tests to see the presence of higher-than-normal levels of bilirubin in the infant’s blood, or by tests to see signs of red blood cell destruction in the infant’s blood.
Symptoms of high bilirubin after delivery would include, yellowing of the skin and whites of the eyes or jaundice, lethargy, and low muscle tone in the baby after delivery.
Preventive treatment is the best kind of treatment to stave off Rh incompatibility. It can be prevented with the use of RhoGAM, a special immune globulin administered during pregnancy.
If the father is Rh-positive or has unknown blood group, the mother is given an injection of RhoGAM during the second trimester.
If the baby is Rh-positive, the mother is given a second injection within a few days after delivery.
As a rule of thumb, women with Rh-negative blood must get injections during every pregnancy, after a miscarriage or abortion, after prenatal tests like amniocentesis and chorionic villus, or after any abdominal injury during pregnancy.
The injections would prevent or delay the development of antibodies against Rh-positive blood that the newborn may have.
If the baby has Rh-positive blood, mothers should get a second injection a few days after delivery too.
Some treatments available for avoiding complications caused due to Rh incompatibility are:
- Blood transfusion – only necessary in very rare and serious cases
- Administering of hydrating fluids
- Electrolytes, which help regulate metabolism
- Phototherapy – involves keeping the baby near fluorescent lights to help reduce the bilirubin in their blood and help remove Rh-negative antibodies, blood group, Rh-positive, Rh-negative,
Rh incompatibility is a serious issue which is generally diagnosed during pre-natal checkups, and one detected, should be closely monitored to keep a count of the unborn baby’s RBC and bilirubin levels.
If left untreated, Rh incompatibility can cause brain damage to the baby; fluid build-up or swelling in the baby (hydrops fetal); trouble with mental function, movement, hearing, and speech; seizures; anaemia; heart failure, or even death in severe cases.