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Rh incompatibility

Email this page to a friend Share on facebook Share on twitter Bookmark & Share Printerfriendly version Rh incompatibility is a condition that develops when a pregnant woman has Rh-negative blood and the baby in her womb has Rh-positive blood.

Causes
D ring pregnancy! red blood cells from the nborn baby can cross into the mother"s bloodstream thro gh the placenta. #f the mother is Rh-negative! her imm ne system treats Rh-positive fetal cells as if they were a foreign s bstance and makes antibodies against the fetal blood cells. $hese anti-Rh antibodies may cross back thro gh the placenta into the developing baby and destroy the baby"s circ lating red blood cells. %hen red blood cells are broken down! they make bilir bin. $his ca ses an infant to become yellow &'a ndiced(. $he level of bilir bin in the infant"s bloodstream may range from mild to dangero sly high. Beca se it takes time for the mother to develop antibodies! firstborn infants are often not affected nless the mother had past miscarriages or abortions that sensiti)ed her imm ne system. *owever! all children she has afterwards who are also Rh-positive may be affected. Rh incompatibility develops only when the mother is Rh-negative and the infant is Rhpositive. $hanks to the se of special imm ne glob lins called Rho+*,-! this problem has become ncommon in the .nited States and other places that provide access to good prenatal care.

Symptoms
Rh incompatibility can ca se symptoms ranging from very mild to deadly. #n its mildest form! Rh incompatibility ca ses the destr ction of red blood cells. ,fter birth! the infant may have/

0ellowing of the skin and whites of the eyes &'a ndice( 1ow m scle tone &hypotonia( and lethargy

Exams and Tests


Before delivery! the mother may have an increased amo nt of amniotic fl id aro nd her nborn baby &polyhydramnios(. $here may be/

, positive direct 2oombs test res lt *igher-than-normal levels of bilir bin in the baby"s mbilical cord blood Signs of red blood cell destr ction in the infant"s blood

Treatment
Beca se Rh incompatibility is preventable with the se of Rho+,-! prevention remains the best treatment. $reatment of an infant who is already affected depends on the severity of the condition. #nfants with mild Rh incompatibility may be treated with/

3eeding and fl ids &hydration( Phototherapy sing bilir bin lights

Outlook (Prognosis)
3 ll recovery is e4pected for mild Rh incompatibility.

Possible Complications
Possible complications incl de/

Brain damage d e to high levels of bilir bin &kernicter s( 3l id b ild p and swelling in the baby &hydrops fetalis( Problems with mental f nction! movement! hearing! speech! and sei) res

When to Contact a

edical Pro!essional

2all yo r health care provider if yo think or know yo are pregnant and have not yet seen a doctor.

Pre"ention
Rh incompatibility is almost completely preventable. Rh-negative mothers sho ld be followed closely by their obstetricians d ring pregnancy. Special imm ne glob lins! called Rho+,-! are now sed to prevent R* incompatibility in mothers who are Rh-negative. #f the father of the infant is Rh-positive or if his blood type cannot be confirmed! the mother is given an in'ection of Rho+,- d ring the second trimester. #f the baby is Rh-positive! the mother will get a second in'ection within a few days after delivery. $hese in'ections prevent the development of antibodies against Rh-positive blood. *owever! women with Rh-negative blood type m st receive in'ections/

D ring every pregnancy #f they have a miscarriage or abortion ,fter prenatal tests s ch as amniocentesis and chorionic vill s biopsy ,fter in' ry to the abdomen d ring pregnancy

#lternati"e $ames
Rh-ind ced hemolytic disease of the newborn

Re!erences
Stoll B5. Blood disorders. #n/ 6liegman R-! Behrman RE! 5enson *B! Stanton B3! eds. Nelson Textbook of Pediatrics. 78th ed. Philadelphia! Pa/ Sa nders Elsevier9 :;;</chap 7;=.

%pdate &ate' ()*+),+-.pdated by/ ,.D.,.-. Editorial $eam/ David >ieve! -D! -*,! and David R. Elt). Previo sly reviewed by 6imberly + 1ee! -D! -Sc! #B212! ,ssociate Professor of Pediatrics! Division of ?eonatology! -edical .niversity of So th 2arolina! 2harleston! S2. Review provided by @eri-ed *ealthcare ?etwork &:A7;A:;77(.

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