Pregnancy Problems Due to Differences in Rhesus Blood of Mother and Child

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Medical Video: How Blood Type Affects Pregnancy Medical Course

As you know, every human being has different blood groups: A, B, O, and AB. Each blood type is again classified based on the protein content called Rhesus (Rh). If your blood type contains rhesus protein, your blood group is classified as rhesus positive (Rh +), usually marked with a symbol (+) behind your blood type (example: A +, B +, AB +, O +). Conversely, if your blood type does not contain rhesus protein, then your blood type is classified as rhesus negative (Rh-), usually marked with a symbol (-) behind your blood group (example: A-, B-, AB-, and O -). Only a small percentage of the world's population (around 15%) has Rh-.

How can we get rhesus positive or rhesus negative?

Rhesus protein is something derived from heredity. Here are some possible factors about your rhesus group:

  • If your father has Rh + and your mother also has Rh +, then you will get Rh +
  • If your father has Rh + and your mother has Rh-, then you will get two possibilities. It could be that you like your father have Rh +, or you like your mother has Rh-
  • If your father has Rh- and your mother has Rh-, then you will get Rh-

What is the relationship between rhesus blood and pregnancy and baby?

Actually, Rh factors do not directly affect health. However, Rh is very influential on pregnant women. If a mother has an Rh-containing baby with Rh +, then there is a risk that occurs in your child, especially in the second pregnancy and so on.

This condition is commonly called Rh incompatibility. When the mother has Rh-while the fetus has Rh +, the mother's body will recognize Rh + as something strange in the mother's body. This means that if the blood cells of the baby meet the mother's blood cells, the mother's immune system will produce antibodies (part of the immune system that fight "foreign bodies" in the body) to fight Rh + blood cells.

Rh Sensitization: the process when the mother's body "fights" positive rhesus from the fetus

Rh Sensitization is a process that occurs in pregnant women after the mother's blood is Rh-mixed or meets the blood of an Rh + fetus. Usually, this process occurs during pregnancy or the birth process, when both maternal and fetal blood are mixed. After the mother's blood cells meet the baby's blood cells, the mother's immune system begins to form antibodies against Rh + red blood cells.

The minimum amount of mixed blood that causes sensitization is not yet known. However, most mothers begin to experience sensitization during pregnancy or birth after being exposed to about 0.1 mL of Rh + blood.

When the mother's immune system that has Rh-first meets Rh + blood cells, it takes several weeks to form immunoglobulin M or IgM antibodies. IgM antibodies are too large to enter the fetus through the placenta. That is why, usually the ill effects of Rh incompatibility do not occur in the fetus in the first pregnancy.

This immune system will continue to react with Rh + blood cells, including during the second pregnancy with an Rh + fetus. Usually, within a few hours of meeting with Rh +, immunoglobulin G antibodies or smaller size IgGs will be formed. IgG antibodies can cross the placenta and damage Rh + red blood cells in the fetus. This can cause Rh disease which is dangerous to the fetus.

Signs of Rh incompatibility

Signs of adverse effects on your baby in a state of Rh Incompatibility can be from mild to life threatening to your fetus. When antibodies fight red blood cells in your baby, your baby can experience hemolytic anemia, which is a disease caused by damage to red blood cells.

When red blood cells in your baby's fetus are damaged, the amount of bilirubin in your baby's blood system will increase. Bilirubin is a chemical formed by the destruction of red blood cells. Too much bilirubin in the body is a sign that the pancreas (the organ responsible for processing old red blood cells) has a problem.

Your baby may experience one or more of the following signs if the baby has a high amount of bilirubin after birth:

  • Skin and sclera (the white part of the eye) is yellow, or often known as jaundice
  • Sluggish
  • Weak muscles

The above signs will subside when treatment for Rh incompatibility has been completed.

How to diagnose Rh incompatibility?

Usually, your doctor will recommend a blood test to determine your Rh status when you first come to the doctor to consult about your pregnancy. If you have Rh-, then maybe your husband is also recommended for a blood test. If your husband also has Rh-, then there is nothing to worry about. However, if your husband is Rh +, the doctor will see if there are any signs of Rh incompatibility:

  • Direct Coombs Test is a test used to test whether autoimmune hemolytic anemia is occurring (a disease that antibodies mistaken for erythrocytes as something "foreign" to the body). This test will be done by taking blood samples to see if there are antibodies that can damage red blood cells. If the results of this test are positive, then that could be signs of Rh incompatibility.
  • Excessive amounts of bilirubin in your newborn can be signs of Rh incompatibility. Usually, babies who are less than 24 hours old have bilirubin levels less than 6.0 mg / dL
  • Symptoms of damage to red blood cells in your baby's blood can also be signs of Rh incompatibility. This can be seen from the shape and structure of your baby's red blood cells when observed under a microscope. Your doctor can test your baby's blood to see if there are antibodies that damage your baby's red blood cells.

Adverse effects if Rh incompatibility is not prevented

In certain cases, if incompatibility is not prevented, this condition can cause several complications, including:

  • Brain damage in infants
  • Problems with mental health, movement, hearing, and speaking ability in children
  • Anemia
  • Convulsions
  • Heart failure
  • Fluid buildup or swelling in the baby
  • Death in infants

How do you handle Rh incompatibility?

Treatment Rh incompatibility is focused on preventing the effects of incompatibility. In mild cases, your baby can undergo treatment after birth such as:

  • Blood transfusion
  • Hydrating fluids
  • Electrolytes, which are elements that regulate metabolism
  • Phototherapy, which is to put your baby close to fluorescent light to help reduce bilirubin levels in your baby. this procedure may be repeated until antibodies that attack the baby's blood cells and the excess amount of bilirubin is lost from the baby's body.

If you are pregnant and your doctor has diagnosed that your body is forming antibodies against your fetus' red blood cells, your pregnancy will be monitored intensely. You can prevent the adverse effects of Rh incompatibility by getting an injection of Rh immune globulins (RhIg) during the first trimester, when a miscarriage occurs, or when bleeding occurs during pregnancy. This product contains antibodies to the Rh factor. If your baby has Rh +, you need to get another injection a few days after you give birth. For serious cases, special blood transfusions can be done when your fetus is still in the womb or after giving birth. However, the success rate of injection of RhIg makes this procedure of transfusion rare.

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Pregnancy Problems Due to Differences in Rhesus Blood of Mother and Child
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