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Rh-Incompatibility
One of the first things your doctor will do after you become pregnant is order a blood-type test. In addition to finding out your type — A, B, AB, or O — the test will determine your Rh factor, which relates to a protein on the surface of red blood cells. If you carry the protein, you are RH positive, just like 85 percent of the people in the world. If not, you are Rh negative.
Sounds simple enough. But what if you are Rh negative and your baby is Rh positive?
This condition occurs in about half the babies born to Rh-negative mothers and Rh-positive fathers. During pregnancy and delivery, the mother's and baby's blood sometimes intermingles. The mother's body, recognizing the Rh protein as a foreign substance, begins to produce antibodies.
It's usually not a problem for a mother in her first pregnancy, since it takes time to build antibodies, but when the second or third baby's Rh-positive blood triggers the antibodies, there can be trouble. The antibodies recognize the Rh proteins on the surface of the baby's blood cells as foreign, so they pass into the baby's bloodstream and attack the cells. The baby's blood cells can rupture and swell, causing a low blood count called hemolytic or Rh disease of the newborn.
How Do I Prevent Rh Disease of the Newborn?
The good news is that Rh incompatibility is fully preventable. Rh-negative mothers are closely monitored during their pregnancy. If the father is Rh positive, the mother receives a mid-term injection of something called RhoGAM, a special immune globulin, and a second injection a few days after delivery. The injections prevent the mother from developing antibodies against Rh-positive blood.
What Do I Do If My Baby Has It?
If, somehow, an incompatible mother and baby do not receive the RhoGAM injections and the condition develops, the symptoms range from mild to fatal for the fetus. It can lead to jaundice, motor and mental retardation, hypotonia, or undertoned muscles, and polyhydramnios, or too much fluid in the amniotic sac. Ask your doctor if you have concerns. The condition can be monitored closely with serial blood draws to check antibody levels, serial ultrasounds and possibly amniocentesis or even sampling the fetal blood from the umbilical cord.
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