Rhesus incompatibility
Rhesus incompatibility occurs when the mother has Rh-negative blood and the fetus has Rh-positive blood usually in the second or later pregnancies[1]. Rh positive indicates the presence of Rhesus factor in the blood and Rh-negative indicates the absence of Rhesus factor in blood. Rhesus incompatibility happens when the mother is Rh-negative recognizing the Rh-positive blood of the baby as non-self[1]. This will cause an immune action triggered in the mother, producing antibodies to attack the red blood cell of the baby. This will lead to complications in newborns such as hemolytic anemia and jaundice[1]. Severe hemolytic anemia may be fatal to the fetus. However, fatality rate is more significant in the second or later pregnancies as the antibodies formed in the first pregnancy is not sufficient to kill the baby.
Causes
Rh incompatibility may occurs in several situation. When the Rh-negative blood of mother exposed to Rh-positive blood of fetus while giving birth or during abortion. However, in some cases Rh incompatibility may be due to mismatch blood transfusion during emergencies when pre-blood transfusion screening is not performed[2].
Complications[1]
Rh incompatibility will not affect the pregnant mother, instead it will cause a series of complications in the baby.
Hemolytic anemia is the most common complication which is a condition where the erythrocytes of newborns damage faster than the erythrocytes produced in the body. The severity of hemolytic anemia depends on the health conditions of the newborn during the first pregnancy and mortality in newborns due to hemolytic anemia are more likely to occur from the second pregnancy onwards.
Full-term babies are subjected to neonatal jaundice which is accumulation of bilirubin, a compound formed due to the breakdown of hemoglobin from dead red blood cells. This occurs during the first 48 hours of a newborn. Severe neonatal jaundice may be fatal[3].
Treatment
Rh immune globulin is a medicine used for Rh incompatibility. This medicine is injected into the mother to prevent the formation of antibodies in the body when there is an exposure to Rh-positive blood. However, this is only a preventive method. If antibodies are formed before taking in the medicine, it will be useful as the antibodies will remain in the body for the rest of the life. To date, there are no treatment to solve this problem.
Reference
1. Erhabor O. Heamolytic Disease of the Foetus and New Born Due to ABO Blood Group Incompatibility between Mother and their Babies in Specialist Hospital Sokoto, Nigeria. SF Obstet Women Health J. 2017;1(2).
2. Loehr J, Marazak F, Genovefa M. Rh Incompatibility in Early Medical Abortion, a Misoprostol Case Report. Scripta Scientifica Vox Studentium. 2017;1(1).
3. Perera TM, Seneviratne LS, Jayah FQ, Sandamali JA, Jayakodi Arachchi SS. " Yellow Babies"-Analysis of Babies Who Were Fund to Have Early Clinical Jaundice.