Rh

Incompatibility
Rh factor
The Rh factor is a specific protein found on the surface
of your red blood cells. Rh stands for rhesus monkey, in
which these antigens were first discovered. People who
have these antigens are said to be Rh+ve, whereas who
do not are called Rh-ve. An Rh-ve person, if exposed to
Rh+ve blood, will form antibodies against the Rh
antigen. Like your blood type, you inherit your Rh factor
type from your parents. Most people are Rh-positive, but
a small percentage of people are Rh-negative. This
means they lack the Rh protein. A positive or negative
symbol after your blood type indicates your Rh factor.
For example, your blood type on your medical records
might read:
Blood type: AB+ or A-

What Is Rh Incompatibility?
When a mother is Rh-ve and the father is Rh+ve, then

their baby will be Rh+ve, in this situation she and her

unborn baby carry different Rh protein factors, their
condition is called Rh incompatibility. It is specifically
caused when a mother is Rh-negative and her baby is
Rh-positive.

The Rh factor does not have a direct effect on

your health. However, Rh factor becomes important
during pregnancy. If a woman is Rh-negative and her
baby is Rh-positive, then her body will determine the Rhpositive protein to be foreign.
This means that if blood cells from the baby cross into
the mothers bloodstream, which can happen
during pregnancy, labor, and delivery, her immune
system, will make antibodies against the babys red
blood cells. Antibodies are part of your bodys
immune system that destroys foreign substances.

Once an Rh-negative mothers body has made these

antibodies, she is considered sensitized to her baby.
This means that her body might send these antibodies
across the placenta (the organ that connects mother and
child) to attack the babys red blood cells.

Medication can help with this condition to ensure that

both the mother and baby are healthy.

Who Is at Risk for Rh

Incompatibility?
Any woman who is Rh-negative and having a child with
a father who is Rh-positive or Rh-unknown is at risk for
Rh incompatibility.
It takes time for the body to develop antibodies, so
firstborn children are usually not affected. However, if a
mother became sensitized prior to a miscarriage or
abortion, her first birth may be affected by Rh
incompatibility.

What Are the Symptoms of Rh

Incompatibility?
The symptoms can range from mild to deadly for your
unborn baby. When the mothers antibodies attack the
babys red blood cells, hemolytic disease can
occur. This means the babys red blood cells are being
destroyed.
When the babys healthy red blood cells are
destroyed, bilirubin will build up in his or her
bloodstream. Bilirubin is a chemical that is the by
product of the broken-down red blood cells. Too much of
it is a sign that the liver, which is responsible for
processing old blood cells, is having trouble.

If bilirubin levels are high after birth, your baby may have
yellowing of the skin and whites of the eyes (jaundice),
lethargy, and/or low muscle tone. These symptoms will
subside once treatment has been completed for the Rh
incompatibility.

Diagnosing Rh Incompatibility
A blood test to determine your Rh status will likely be
done at your first prenatal visit with your doctor. If you
are Rh-negative, your doctor will look for the following
during your pregnancy and following delivery:

the amount of amniotic fluid around the baby.

Normally there is about 5 centimeters of fluid. These
levels can vary depending on how far along you are in
your pregnancy, however. If you have Rh incompatibility,
the level of amniotic fluid will be higher than normal.

a positive direct Coombs test. This test uses a

blood sample to look for the presence of cell-destroying
antibodies on the surface of your red blood cells.

Higher-than-normal levels of bilirubin in the infants

blood. In a full-term baby that is fewer than 24 hours old,
the levels should be less than 6.0 mg/dL (milligrams per
deciliter).

Signs of red blood cell destruction in the infants

blood. This can be indicated by the shape and structure
of the red blood cells when examined under a
microscope. Additionally, your doctor can test your

babys blood for the presence of antibodies that are

breaking down the red blood cells.

Treating Rh Incompatibility
Treatment focuses on preventing the effects of the
incompatibility. In mild cases, the baby can be treated
after birth with a series of blood transfusions, hydrating
fluids and electrolytes (the elements that regulate
metabolism), or phototherapy. Phototherapyinvolves
keeping the baby near fluorescent lights to help reduce
the bilirubin in his or her blood. These procedures may
be repeated until the Rh-negative antibodies and excess
bilirubin have been removed from the babys blood.
Whether it must be repeated depends on the severity of
the infants condition.
If you are pregnant and your doctor determines that you
have already developed antibodies against your child,
your pregnancy will be closely monitored. In some
cases, a series of special blood transfusions can be
performed while the baby is in utero or after delivery.
This is performed in less than one percent of Rh
incompatible pregnancies in the UnitedStates, according
to the Nemours Foundation. (Kids Health)
The effects of Rh incompatibility can be prevented by
giving the mother an injection of Rh immune globulins
(RhIg) during her first trimester of pregnancy. This blood
product contains antibodies to the Rh factor. If the baby

has Rh-positive blood, the mother gets a second

injection a few days after she gives birth.

Observation
In mild cases of Rh incompatibility no major problem is
experienced
In Severe cases, in which the effects of Rh
incompatibility are not prevented, can result in anemia,
brain damage, and heart failure in newborns. It can
cause the babys death in extreme cases.
In some cases it can cause:

brain damage to the fetus

fluid buildup or swelling in the baby
trouble with mental function, movement, hearing,
and speech

Seizures.
Rh incompatibility is rarely a problem in countries with
good medical care.

Prevention and precaution to

avoid Rh Incompatibility
This condition is completely preventable. If you think you
may be pregnant and have an Rh-negative blood type,

you should talk with your doctor to determine the best

course of action. If the father of the child is Rh-positive
or his blood type is unknown, receiving preventive
treatment with immune globulins will prevent serious
effects of the condition.
You will need to receive immune globulins during every
pregnancy, if you have a miscarriage or abortion, after
any prenatal tests (such as amniocentesis), or after
an injury to the abdomen during pregnancy. They may
also be necessary after receiving a blood transfusion
with Rh-positive blood.