RH INCOMPATIBILITY

 Basic information

description

Rh incompatibility is a difference between an infant's blood type and that of its mother. This results in the destruction of the infant's red blood cells during pregnancy and after birth by antibodies from its mother's blood.

FREQUENT SIGNS & SYMPTOMS

• Symptoms affect the fetus or newborn.
• Excessive amniotic fluid around the fetus.
• Jaundice (yellow skin and eyes) that begins within 24 hours after delivery.
• Infant has floppy or decreased muscle tone.

causes

The baby of an Rh-negative (blood type) mother and an Rh-positive father may be Rh-positive. If the father is known to be Rh negative, there is no concern. During pregnancy, but more commonly during delivery, a small amount of the infant's blood is absorbed by the mother through the placenta, stimulating her body to produce antibodies against Rh-positive blood. The antibodies are produced after delivery, so the first infant is not affected. With each subsequent pregnancy, anti-Rh antibodies cross the placenta and may destroy fetal blood cells. The resulting anemia can be severe enough to cause fetal death. If the fetus survives, antibodies can cross to the baby during birth, causing jaundice and other symptoms shortly after birth.

risk increases with

Each pregnancy after the first one that involved different blood types. This includes ectopic pregnancies and spontaneous (miscarriage) and elective abortions.

PREVENTIVE MEASURES

Medical care early in pregnancy is important to determine the risk of Rh incompatibility and provide treatment if needed.

expected outcomes

With prompt diagnosis, monitoring, and treatment, the outcome is generally good. Complications are rare.

possible complications

• Complications may develop from procedures such as amniocentesis or cordocentesis.
• Emergency delivery of the baby may be required.
• Hydrops fetalis in the newborn. This involves severe edema (swelling), heart, lung, and liver problems.
• Mental deficiency, movement disorders, seizures, or hearing or speech problems.

 diagnosis & treatment

general measures

• Blood tests are done to type the mother's, father's, and infant's blood, measure the mother's Rh-positive antibodies, and to detect anemia in the infant's blood.
• Amniocentesis may be done. A small amount of amniotic fluid is withdrawn from the amniotic sac that surrounds the unborn child in the uterus for a diagnostic procedure. It can be used sometimes to determine the fetal blood type.
• Cordocentesis (percutaneous umbilical blood sampling [PUBS]) may be recommended. It is done to determine fetal blood type and the degree of anemia.
• Intrauterine blood transfusions (sometimes).
• Transfusion to completely exchange the infant's blood after birth.
• Hospital care. The newborn child will remain in the hospital up to 2 weeks after an exchange transfusion.
• If you have an Rh-negative blood type, tell any health care provider who treats you. Be sure this information is in your medical records. Wear a medical alert type bracelet or pendant to identify your medical problem.

medications

If you are pregnant and have Rh-negative blood type, you will be prescribed an anti-Rh gamma globulin injection (RhoGAM) at 28 weeks and again within 72 hours after delivery or at the end of a pregnancy for any reason. You may have an antibody titer drawn during pregnancy to see if you are producing anti-Rh antibodies. You do not need RhoGAM if your fetus is Rh-negative.

activity

No limits after treatment.

diet

No special diet.

 notify our office if

You have further questions about RH incompatibility.

Special Notes: