Rhesus incompatibility

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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 the Rhesus factor in blood[2]. Rhesus incompatibility happens when the mother is Rh-negative recognising the Rh-positive blood of the baby as non-self[3]. 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 anaemia and jaundice[4]. Severe hemolytic anaemia may be fatal to the fetus. However, the 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.

Contents

Causes

Rh incompatibility may occur in several situations. When the Rh-negative blood of mother exposed to Rh-positive blood of fetus while giving birth or during an abortion. However, in some cases, Rh incompatibility may be due to mismatch blood transfusion during emergencies when pre-blood transfusion screening is not performed[5].

Complications

Rh incompatibility will not affect the pregnant mother. Instead, it will cause a series of complications in the baby. Hemolytic anaemia 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 anaemia depends on the health conditions of the newborn during the first pregnancy and mortality in newborns due to hemolytic anaemia are more likely to occur from the second pregnancy onwards[6].Full-term babies are subjected to neonatal jaundice which is an accumulation of bilirubin, a compound formed due to the breakdown of haemoglobin from dead red blood cells. This occurs during the first 48 hours of birth. Severe Jaundice may be fatal[7].

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 is no yet a treatment to solve this problem completely[8].

Reference

  1. Erhabor O. Haemolytic 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. Sarhan MA, Saleh KA, Bin-Dajem SM. Distribution of ABO blood groups and rhesus factor in Southwest Saudi Arabia. Saudi medical journal. 2009;30(1):116-9.
  3. Erhabor O. Haemolytic 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).
  4. Erhabor O. Haemolytic 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).
  5. Loehr J, Marazak F, Genovefa M. Rh Incompatibility in Early Medical Abortion, a Misoprostol Case Report. Scripta Scientifica Vox Studentium. 2017;1(1).
  6. Erhabor O. Haemolytic 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).
  7. Perera TM, Seneviratne LS, Jayah FQ, Sandamali JA, Jayakodi Arachchi SS. " Yellow Babies"-Analysis of Babies Who Were Fund to Have Early Clinical Jaundice.
  8. Shaz BH. Rh Immune Globulin. InTransfusion Medicine and Hemostasis 2009 (pp. 205-208).
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