Written by Dr.M.D.Mazumdar, MD
Rh-ve pregnancy is a pregnancy in which the mother's blood group is Rh-ve and the baby's blood group is Rh+ve, inherited from the father. Its importance lies in the fact that this difference in the Rh factor can produce complications in the baby.
Also known as Rhesus incompatibility or Rhesus disease, it is one of the causes of hemolytic disease of the newborn (HDN / RhD Hemolytic Disease of the Newborn).
The Rhesus factor is a surface protein found on red blood cells. People who have this factor are said to be Rh positive while people who do not have this protein are said to be Rh negative.
The percentage of people who have the Rh factor is more than those who do not have this factor.
In the United States, about 15 percent of the white population, 5 to 8 percent of the African-American and Hispanic populations, and 1 to 2 percent of the Asian and Native American populations are Rh-negative. (Marchofdimes.com).
The main problem with the Rh factor occurs when the blood of an Rh negative person comes in contact with the blood of an Rh positive person. This causes the Rh negative person to develop antibodies against the Rh factor. These antibodies never go away and the person is said to be sensitized against the Rh factor.
If an Rh negative woman becomes pregnant with an Rh positive baby (the baby can inherit the Rh factor from an Rh positive father), the baby's blood enters the mother's blood circulation sometime during the pregnancy, usually at around 28 weeks.
The mother's blood cells recognizes the foetal cells as foreign and produces Anti-Rh antibodies to destroy the cells. Her blood thus becomes sensitized against the Rh factor. When this sensitized blood carrying the antibodies re-enters the baby, it can attack the baby's blood cells causing them to break down. This can cause acute problems in the baby. The symptoms are usually more acute in the second baby which follows the first pregnancy, rather than in the baby which causes the sensitization.
The anti-Rh factors have no effect on the mother's cells, but can destroy the fetal red blood cells whenever they come in contact.
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Some conditions can cause leakage of small amounts of fetal blood into the mother's blood circuation.
Since it is the baby who is affected, there are no significant signs and symptoms in the mother.
The disease ranges from mild to severe.
Hydrops Fetalis : This is the most severe complication of Rh-ve pregnancy, where the baby suffers from widespread tissue damage. There is edema, enlarged liver and spleen and the baby may die in the uterus.
Hemolytic Anaemia : The baby has anemia at birth due to destruction of RBC's. Blood Transfusion is necessary.
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