All Woman

Your pregnancy: Rh incompatibility

Wednesday, June 25, 2014    

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Rhesus (Rh) factor is an inherited trait that refers to a specific protein found on the surface of red blood cells. If your blood has the protein, you're Rh positive — the most common Rh factor. If your blood lacks the protein, you're Rh negative.

Although Rh factor doesn't affect your health, it can affect pregnancy. Your pregnancy needs special care if you're Rh negative and your baby's father is Rh positive.

If you're pregnant, your health care provider will recommend an Rh factor test during your first prenatal visit. The Rh factor test is a basic blood test that indicates whether you're Rh positive or Rh negative.

The Rh factor test is done during pregnancy to identify a woman's Rh factor. In some cases, the baby's father might need an Rh factor test, too.

During pregnancy — or, more likely, during delivery — a small amount of your baby's blood could come in contact with your blood. If you're Rh positive, Rh incompatibility isn't a concern. If you're Rh negative and your baby is Rh positive, however, your body might produce Rh antibodies after exposure to the baby's red blood cells.

Typically, the antibodies aren't a problem during the first pregnancy. The concern is with a subsequent pregnancy with an Rh positive baby. In this case, your existing Rh antibodies might cross the placenta and fight the baby's red blood cells. This could lead to life-threatening anaemia — a lack of healthy red blood cells — for the Rh positive baby.

If you're Rh negative, you might need to have another blood test — an antibody screen — during your first trimester and again during week 28 of pregnancy. The antibody screen is used to detect antibodies to Rh positive blood.

If you haven't started to produce Rh antibodies, you'll need an injection of a blood product called Rh immune globulin. The immune globulin prevents your body from producing Rh antibodies during your pregnancy.

If your baby is born Rh negative, no additional treatment is needed.

If your baby is born Rh positive, you'll need another injection shortly after delivery. You'll likely need injections during any subsequent pregnancies and after the delivery of each Rh positive baby as well.

If you're Rh negative, you'll also need an Rh immune globulin injection after any situation in which your blood could come into contact with Rh positive blood, including:

* Miscarriage

* Abortion

* Ectopic pregnancy

* Molar pregnancy — a noncancerous (benign) tumour that develops in the uterus

* Amniocentesis

* Bleeding during pregnancy

* Blunt trauma to the abdomen during pregnancy

* Rotation of a baby in a breech position — such as buttocks first — before labour

If the antibody screen shows that you're already producing antibodies, an injection of Rh immune globulin won't help. Your baby will be carefully monitored. If necessary, he or she might be given a blood transfusion through the umbilical cord during pregnancy or immediately after delivery.

—Mayo Clinic

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