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| Aug 23 2006, 2:11 PM EDT | wetpaint | 1 word added, 9 words deleted |
| Aug 21 2006, 4:49 PM EDT | wetpaint | 3 words added, 3 words deleted |
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One of the first tests performed at the beginning of a pregnancy is blood-type. This basic test determines your blood type and Rh factor. People with different blood types have proteins specific to that blood type on the surfaces of their red blood cells.
There are four blood types (A, B, AB, and O). Each of the four blood types is additionally classified according to the presence of another protein on the surface of red blood cells that indicates your Rh factor. If you carry this protein, you are Rh positive. If you don't carry the protein, you are Rh negative.
About 85% of people are Rh positive. But if a woman who is Rh negative and a man who is Rh positive conceive a baby, there is the potential for incompatibility.
The baby growing inside the Rh-negative mother may have Rh-positive blood, inherited from the father. Statistically, at least 50% of the children born to an Rh-negative mother and Rh-positive father will be Rh positive.
Rh incompatibility occurs when a woman is Rh-negative, but her fetus has inherited Rh-positive blood from the father. It rarely occurs in a woman's first pregnancy. She only becomes sensitized to the fetus's Rh-positive blood if she comes in contact with it.
This is usually not until childbirth, but it can also occur during a miscarriage, if the fetus is aborted, or due to other trauma such as amniocentesis or other invasive procedures related to pregnancy. A woman can also become sensitized to Rh-positive blood if she receives an incompatible blood transfusion.
A risk factor is something that increases your chance of getting a disease or condition.
Symptoms and complications only affect the fetus and/or newborn. They occur when standard preventive measures are not taken and can vary from mild to very serious. The mother's health is not affected.
Symptoms of the newborn baby include:
There aren't any physical symptoms that would allow you to detect on your own if you are Rh incompatible with any given pregnancy. If you are pregnant, it is standard procedure for your health-care provider to order a blood test that will determine whether you are Rh positive or Rh negative.
If the blood test indicates that you have developed Rh antibodies, your blood will be monitored regularly to assess the level of antibodies it contains. If the levels are high, an amniocentesis may be performed to determine the degree of impact on the fetus.
Rh incompatibility is almost completely preventable with the use of Immune Globulin Injection of RhoGAM.
You will be offered an injection of Rh0 immune globulin at week 28 of the pregnancy. This desensitizes your blood to Rh-positive blood. You will also have another injection of immune globulin within 72 hours after delivery (or miscarriage or abortion) if the baby’s blood is Rh-positive. This further desensitizes your blood for future pregnancies.
Treatment of a pregnancy or newborn depends on the severity of the condition.
Full recovery is expected for mild Rh incompatibility. Both hydrops fetalis and kernicterus represent extreme conditions caused by hemolysis. Both have guarded outcomes. Hydrops fetalis has a high mortality rate. Long-term problems can result from severe cases. These can include:
Rh incompatibility is almost completely preventable. Rh negative mothers should be monitored closely during pregnancy. If the father of the infant is Rh positive, the mother is given a mid-term injection of RhoGAM and a second injection within a few days of delivery.
These injections prevent the development of antibodies against Rh positive blood. This effectively prevents the condition. Routine prenatal care should help identify, manage, and treat any complications of Rh incompatibility.
There are four blood types (A, B, AB, and O). Each of the four blood types is additionally classified according to the presence of another protein on the surface of red blood cells that indicates your Rh factor. If you carry this protein, you are Rh positive. If you don't carry the protein, you are Rh negative.
About 85% of people are Rh positive. But if a woman who is Rh negative and a man who is Rh positive conceive a baby, there is the potential for incompatibility.
The baby growing inside the Rh-negative mother may have Rh-positive blood, inherited from the father. Statistically, at least 50% of the children born to an Rh-negative mother and Rh-positive father will be Rh positive.
Causes
Rh incompatibility occurs when a woman is Rh-negative, but her fetus has inherited Rh-positive blood from the father. It rarely occurs in a woman's first pregnancy. She only becomes sensitized to the fetus's Rh-positive blood if she comes in contact with it.
This is usually not until childbirth, but it can also occur during a miscarriage, if the fetus is aborted, or due to other trauma such as amniocentesis or other invasive procedures related to pregnancy. A woman can also become sensitized to Rh-positive blood if she receives an incompatible blood transfusion.
Risk factors
A risk factor is something that increases your chance of getting a disease or condition.
- Being a pregnant woman with Rh-negative blood who had a prior pregnancy with a fetus that was Rh-positive
- Being a pregnant woman who had a prior blood transfusion or amniocentesis
Symptoms
Symptoms and complications only affect the fetus and/or newborn. They occur when standard preventive measures are not taken and can vary from mild to very serious. The mother's health is not affected.
Symptoms of the newborn baby include:
- Anemia
- Swelling of the body, which may be associated with:
- Heart failure
- Respiratory problems
- Kernicterus (a neurological syndrome), which can occurs in stages:
- Early:
- High bilirubin level (greater than 18 mg/cc)
- Extreme jaundice
- Absent Moro (startle) reflex
- Poor suck
- Lethargy
- Intermediate:
- High-pitched cry
- Arched back with neck hyperextended backwards (opisthotonos)
- Bulging fontanel (soft spot)
- Seizures
- Late:
- High-pitched hearing loss
- Mental retardation
- Muscle rigidity
- Speech difficulties
- Seizures
- Movement disorder
Diagnosis
There aren't any physical symptoms that would allow you to detect on your own if you are Rh incompatible with any given pregnancy. If you are pregnant, it is standard procedure for your health-care provider to order a blood test that will determine whether you are Rh positive or Rh negative.
If the blood test indicates that you have developed Rh antibodies, your blood will be monitored regularly to assess the level of antibodies it contains. If the levels are high, an amniocentesis may be performed to determine the degree of impact on the fetus.
Treatment
Rh incompatibility is almost completely preventable with the use of Immune Globulin Injection of RhoGAM.
Immune globulin injection
You will be offered an injection of Rh0 immune globulin at week 28 of the pregnancy. This desensitizes your blood to Rh-positive blood. You will also have another injection of immune globulin within 72 hours after delivery (or miscarriage or abortion) if the baby’s blood is Rh-positive. This further desensitizes your blood for future pregnancies.
Treatment to newborn
Treatment of a pregnancy or newborn depends on the severity of the condition.
- Mild:
- Aggressive hydratuion
- Phototherapy using bilirubin lights
- Hydrops fetalis:
- Amniocentesis to determine severity
- Intrauterine fetal transfusion
- Early induction of labor
- A direct transfusion of packed red blood cells (compatible with the infant's blood) and also exchange transfusion of the newborn to rid the blood of the maternal antibodies that are destroying the red blood cells
- Control of congestive failure and fluid retention
- Kernicterus:
- Exchange transfusion (may require multiple exchanges)
- Phototherapy
Outcome
Full recovery is expected for mild Rh incompatibility. Both hydrops fetalis and kernicterus represent extreme conditions caused by hemolysis. Both have guarded outcomes. Hydrops fetalis has a high mortality rate. Long-term problems can result from severe cases. These can include:
- Cognitive delays
- Movement disorders
- Hearing loss
- Seizures
Prevention
Rh incompatibility is almost completely preventable. Rh negative mothers should be monitored closely during pregnancy. If the father of the infant is Rh positive, the mother is given a mid-term injection of RhoGAM and a second injection within a few days of delivery.
These injections prevent the development of antibodies against Rh positive blood. This effectively prevents the condition. Routine prenatal care should help identify, manage, and treat any complications of Rh incompatibility.
- Alternative Therapies Diet and Exercise
- Pregnancy Week by Week
- Possible PrenatalPregnancy Complications
- Prenatal Care
- Prenatal Testing Weight Gain
