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Rh disease occurs during pregnancy. It happens when the Rh factors in the mom’s and baby’s blood don’t match. It may also happen if the mom and baby have different blood types.
Each person has a blood type (O, A, B, or AB). Everyone also has an Rh factor (positive or negative).
The Rh factor is a protein on the covering of the red blood cells. If the Rh factor protein is on the cells, the person is Rh positive. If there’s no Rh factor protein, the person is Rh negative.
A baby may have the blood type and Rh factor of either parent, or a combination of both parents.
There can be a problem when an Rh negative mother has a baby with an Rh positive father. If the baby's Rh factor is positive, like his or her father's, this can be an issue if the baby's red blood cells cross to the Rh negative mother. When this happens, the mom becomes sensitized to Rh positive blood.
This often happens at birth when the placenta breaks away. But it may also happen any time the mom’s and baby's blood cells mix. This can occur during a miscarriage or fall. It may also happen during a prenatal test. These can include amniocentesis or chorionic villus sampling. These tests use a needle to take a sample of tissue. They may cause bleeding.
The Rh negative mom’s immune system sees the baby's Rh positive red blood cells as foreign. Your immune system responds by making antibodies to fight and destroy these foreign cells. Your immune system stores these antibodies in case these foreign cells come back again. This can happen in a future pregnancy. You are now Rh sensitized.
Rh sensitization normally isn’t a problem with a first pregnancy. Most issues occur in future pregnancies with another Rh positive baby. During that pregnancy, your antibodies cross the placenta to fight the Rh positive cells in your baby's body. As the antibodies destroy the cells, your baby gets sick. Your baby could have jaundice, heart failure, and enlarged organs.
Women who are Rh negative and are pregnant with a baby whose father is Rh positive are at risk for this condition. Your risk is much higher if you’ve been pregnant before. There is normally no risk for Rh disease during a first pregnancy, unless you’ve been sensitized before pregnancy.
A mother has no signs of Rh disease. But your baby can have problems if you develop antibodies.
Symptoms can occur a bit differently in each pregnancy and child. During pregnancy, symptoms may include:
Rh disease can cause problems in your newborn. The condition caused by Rh disease in babies is called hemolytic disease of the newborn (HDN). Your baby may have the following symptoms:
The symptoms of Rh disease may look like symptoms of other conditions. See your healthcare provider for a diagnosis.
Your healthcare provider may suspect Rh disease if you had an Rh positive baby in a past pregnancy. Your healthcare provider will ask you about your health history. He or she will also give you an exam.
You may need the following tests to check for Rh disease:
Treatment will depend on your pregnancy and general health. It will also depend on how severe the condition is.
This test puts red blood cells into your baby's circulation. In this test, a needle is placed through your uterus. It goes into your baby’s abdominal cavity to a vein in the umbilical cord. Your baby may need sedative medicine to keep him or her from moving. You may need to have more than one transfusion.
If your baby gets certain complications, he or she may need to be born early. Your healthcare provider may induce labor once your baby has mature lungs.
Complications from Rh disease in your baby may include:
After birth, your baby may have the following:
Rh disease can be prevented. Almost all women will have a blood test to learn their blood type early in pregnancy.
If you’re Rh negative and have not been sensitized, you’ll get a medicine called Rh immunoglobulin (RhoGAM). This medicine can stop your antibodies from reacting to your baby’s Rh positive cells. You’ll get RhoGAM around week 28 of pregnancy. You may get it earlier if you have vaginal bleeding, trauma, or amniocentesis before 28 weeks.
If your baby is Rh positive, you’ll get a second dose of medicine within 72 hours of giving birth. If your baby is Rh negative, you won’t need a second dose.
Call your healthcare provider if you’re Rh negative and have vaginal bleeding or trauma during your pregnancy. Your healthcare provider may give you RhoGAM.
Tips to help you get the most from a visit to your healthcare provider:
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