Rh Factor Incompatibility
GENERAL INFORMATION:
What is Rh factor incompatibility? Rhesus (REE-sus) factor, or Rh factor incompatibility is a red blood cell mismatch between a mother and the baby she is carrying. Rh factor is a protein found on red blood cells and is either positive or negative. You are Rh positive (Rh+) if you have this protein in your blood. You are Rh negative (Rh-) if you do not have it. Rh factor problems happen when you are Rh negative and you are carrying an Rh positive baby. This may happen if the father of your baby is Rh positive. Rh problems usually have little effect on your first pregnancy, but can cause problems with future pregnancies.
What causes an Rh factor problem? If your baby's blood gets into your bloodstream, your body's immune (body defense) system will think the Rh positive blood is foreign. Your body will start making antibodies (substances that protect the body from outside invaders) against the Rh factor. When you get pregnant again with an Rh positive baby, these antibodies will become active. Sometimes having an abnormal pregnancy, abortion, miscarriage, or injury in the abdomen (stomach) can also make these antibodies active. These antibodies can cross over into your baby's bloodstream and cause serious problems in your unborn baby.
What are the signs and symptoms of an Rh factor problem? There are no signs and symptoms that will tell you if you have an Rh factor problem. The Rh antibodies attacking your baby's blood can cause hemolytic disease (red blood cells swell and burst). This may cause your baby to have anemia (low red blood cell count) and jaundice (yellowing of the skin and eyes). Your baby may also have hydrops fetalis, a condition where the whole body swells with fluid. In some cases, the condition worsens and leads to brain damage, heart failure, and even death.
How is an Rh factor problem diagnosed? Caregivers need to know if you have been pregnant before or if you have received a blood transfusion. The following tests may be done:
- Amniocentesis: This test checks for problems in the amniotic fluid (fluid around your baby). Using an ultrasound to guide them, caregivers take a fluid sample by putting a needle through your skin and into your uterus. The sample will then be sent to the lab for tests. Amniocentesis may be done several times to monitor your baby's risk of anemia.
- Blood tests: These tests check your blood type to see if you have antibodies to Rh factor. Blood tests to check the father's blood type and Rh factor may also be done.
- Fetal biophysical profile: A fetal biophysical profile is a test that combines the nonstress test and a special ultrasound of your unborn baby. The nonstress test measures changes in your baby's heartbeat during movement. The ultrasound will show your baby's movement, how his muscles are working, and the amount of fluid around him. It will also show if your baby's breathing muscles are working.
- Fetal blood sampling: This test may be done to check your baby's blood type and risk of anemia. Caregivers take a sample of your baby's blood from the umbilical cord. With an ultrasound to guide them, a needle is put through your skin, into your uterus, and into the umbilical cord. The sample will then be sent to the lab for tests.
- Ultrasound: This test uses sound waves to show pictures of your baby (fetus) inside your uterus (womb). Caregivers can learn the age of your baby and see how fast he is growing. The movement, heart rate, and other organs of your baby can be seen. Your placenta (tissue in the womb connecting the mother and baby) and amniotic fluid may be checked. A doppler ultrasound may be used in place of an amniocentesis to see the blood flow in your baby's body. Caregivers may use this test to check if your baby has anemia.
How is an Rh factor problem treated? The best way to treat an Rh factor problem is to prevent antibodies from forming. Once you have Rh antibodies, there is no treatment to stop them from attacking your baby's blood. Your baby may need blood transfusions while still in the womb. These transfusions may be given through the umbilical cord. Sometimes early delivery (birth) of the baby may be needed.
How can an Rh factor problem be prevented? You may prevent an Rh factor problem by having Rh immune globulin (RhIg) shots. These shots contain Rh antibodies, so that your body does not have to make them. These antibodies attack the baby's red blood cells in your blood. RhIg shots are usually given in the 28th week of pregnancy and within 72 hours after giving birth. Another shot may be given if you have not given birth within 12 weeks after the first shot. RhIg shots may also be given after having an abortion, miscarriage, or abdominal (stomach) trauma. Shots are also given after having any procedure that may cause your baby's blood to leak into your bloodstream. These procedures may include amniocentesis, fetal blood sampling, or changing the baby's position in the womb before birth.
Where do I find support and more information? Having an Rh factor problem may be life-changing for you and your family. Accepting that you and your baby have an Rh factor problem may be hard. You may feel sad or scared. Talk about your feelings with your caregiver or someone close to you. Contact the following for more information:
- American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-913-906-6000
Web Address: http://www.aafp.org
- The American College of Obstetricians and Gynecologists
409 12th Street, SW
Washington, DC 20090
Phone: 1-202-638-5577
Web Address: http://www.acog.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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