Being The Parent

Rh Incompatibility – Causes, Symptoms, Diagnosis & Treatment

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Once the Rh incompatibility test result turns out to be positive, lots of doubts and worries may arise. The blood group, which never causes any trouble until pregnancy, can develop complications during pregnancy. This complication is called Rh incompatibility, which usually will not create many issues during the first pregnancy, but can have a significant effect on subsequent pregnancies. Continue reading to get an overall idea of Rh Incompatibility.
Rh disease

All About Rh Incompatibility

It is a medical condition that happens over the course of pregnancy if the pregnant woman is Rh-negative blood type (RBC without Rh factor) and the blood type of her unborn baby is Rh-positive (RBC with Rh factor). As both mother and child have different blood types, it will develop an inconsistency or Rh incompatibility.

What Is Rh Factor?

There are four basic blood types. A, B, O, and AB. All these blood types carry a particular protein known as the Rh factor on the surface of each blood cell. However, a small percentage of people have blood cells, which do not carry Rh factor. Rh+ refers to the presence of Rh factor, while Rh-ive refers to its absence. Similar to the blood type, the Rh factor type is also inherited from the parents. Majority of the people have Rh-positive type of blood.

Causes Of Rh Incompatibility

Once the pregnant woman has Rh-negative blood type and her unborn baby has Rh-positive blood type, then pregnant woman’s body will mistake the Rh-positive protein in the blood of the unborn baby as an outside substance. The blood from the baby can get into the mother’s blood stream, any time during pregnancy, labor, or (most probably) during the time of delivery. If this happens, the immune system of the mother will develop antibodies against her own unborn baby’s red blood cells. These antibodies might cross the placenta to attack the baby’s red blood cells. These antibodies, generally, do not create issues if the woman is pregnant for the first time. It is due to the fact that the baby is usually delivered before the antibodies in the blood increases.
Once the antibodies have been formed, they stay in the woman’s body. The body will make more Rh antibodies in successive pregnancies. Therefore, Rh incompatibility tends to cause complications in the next pregnancy.

Complications Due To Rh Incompatibility

Rh incompatibility will cause hemolytic anemia in the unborn baby. This means that red blood cells in the body are destroyed sooner than the body’s ability to replace them. Oxygen is carried to different body parts through the red blood cells. So if the red blood cells are not sufficient, the baby will not the desired amount of oxygen. It can cause significant problems.

  • As the result of breaking down of RBC, hemolytic anemia can develop. Depending on the severity of the hemolytic anemia, it can be lethal as chances of edema and heart failure increases
  • Breaking down of RBC can result in the formation of a chemical called bilirubin, which can give rise to jaundice in newborns
  • Increased amount of bilirubin after birth – hyperbilirubinemia – can result in an enlarged liver and spleen, severe jaundice, and even can prompt cerebral palsy in some cases
Symptoms Of Rh Incompatibility

As explained above, Rh incompatibility affects the unborn baby and some symptoms will be seen in them. Some of the signs that show up in the baby are:

  • Low muscle tone
  • Symptoms of jaundice like yellowish color of the skin and the white part of the eyes
  • Lethargy
Who Are At The Risk Of Rh Incompatibility?

Before pregnancy, if by any chance the mother to be is exposed to Rh positive blood, then she is at a higher risk of Rh incompatibility. This exposure may happen:

If the mother to be is not given RhoGam shot that averts Rh antibodies after any of the above exposures, then she will be at risk of Rh incompatibility in her existing and all subsequent pregnancies
Rh incompatibility

Diagnosing Rh Incompatibility

A blood test will likely be undertaken during the first prenatal visit to check if the pregnant woman is Rh-positive blood type or Rh-negative blood type.

  • If the mother to be is Rh-negative blood type, the doctor may ask for father’s blood group. If the father to be is also Rh-negative blood type, there is nothing to worry about
  • If the father to be is Rh-positive blood type and the mother to be is Rh-negative blood type, then the baby can have higher chances of being Rh-positive blood type. Certain screening tests will help the doctor to determine whether the mother to be is at any risk of Rh incompatibility
  • A positive direct Coombs test is an indication of Rh incompatibility. This test uses a blood sample to check for antibodies that are attached to the surface of your red blood cells
  • Diagnosing higher-than-normal levels of bilirubin in the infant’s blood shows Rh incompatibility
  • Signs of red blood cell destruction in the baby’s blood are signs of Rh incompatibility. By examining the size and shape of RBC of the baby under microscope helps to find it out
Treating Rh Incompatibility

The objective of treating this is to make sure that the newborn is fine and bringing down the risk of Rh incompatibility in the subsequent pregnancies. If the mother possesses a risk of developing Rh incompatibility, the doctor will closely monitor the mother and child throughout the pregnancy and prescribe treatment as required. The doctor may prescribe an injection called Rh immune globulin or RhoGam. It will keep the mother’s blood from making any Rh antibodies that attack the baby’s blood. A woman whose blood is Rh-negative should be given RhoGam shot during her current and future pregnancies or any other incidence in which there are chances of her blood getting mixed with the Rh-positive type of blood.
Treatment for a baby who has hemolytic anemia will vary with respect to the severity of the condition.

  • For mild and moderate hemolytic anemia, the treatment involves
    • Phototherapy: The newborn is treated with special lights to reduce the amount of bilirubin in their blood
    • Medicines: Certain medicines and supplements are given to the baby which help the baby’s body to create RBCs
  • For severe hemolytic anemia
    • Blood transfusion is recommended for the baby
    • If the baby can stand a preterm birth, the doctor induces the labor and the blood transfusion is done in the baby. In this process the newborn’s blood will be gradually removed and replaced with new blood




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