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Rhesus Negative Factor. Why does it matter?

Discovering that you possess something that others do not can be intimidating at times. However, gaining knowledge about the Rhesus negative factor and its management can help alleviate this fear significantly.


Continue reading to learn more about the significance of the rhesus factor and why it is important.

Blood Types & the Rhesus Factor


Human blood types are categorized based on the presence or absence of antigens on the surface of red blood cells. These types are A, B, AB, and O. Another important factor is the Rhesus (Rh) factor, which can be either positive (Rh+) or negative (Rh-). Around 85% of people are Rh-positive, while the remaining 15% are Rh-negative.


The Rh factor is particularly important in pregnancy. If a pregnant woman is Rh-negative and the fetus is Rh-positive, her body may produce antibodies that attack the fetus’s red blood cells—a condition known as Rh incompatibility. This can lead to haemolytic disease of the newborn (HDN), where the baby’s red blood cells are destroyed faster than they can be replaced.


Management


Proper management involves administering anti-D immunoglobulin to Rh-negative mothers during pregnancy and after delivery if the baby is Rh-positive. This injection prevents the mother's immune system from recognizing Rh-positive cells and creating antibodies. If this treatment is not given, especially after events like miscarriage, trauma, or delivery, the risk of Rh sensitization increases substantially.


"If a woman becomes sensitized during her first pregnancy, she is at significant risk for complications in all future Rh-positive pregnancies. Proper administration of RhoGAM during pregnancy and postpartum can almost entirely prevent these issues"​. - Dr. Mark Alan

Mismanagement of Rh- negative woman and future pregnancies


Mismanagement of an Rh-negative pregnant woman can have serious consequences for future pregnancies. If an Rh-negative woman carries an Rh-positive baby and does not receive proper medical intervention, her body may produce antibodies that can attack the red blood cells of any future Rh-positive fetuses. This condition is known as Rh sensitization and can lead to haemolytic disease of the newborn (HDN) in subsequent pregnancies.


  1. Rh Sensitization: If an Rh-negative mother becomes sensitized to Rh-positive blood (either through an earlier pregnancy, miscarriage, or blood transfusion), her immune system will produce antibodies that remain in her body. These antibodies can cross the placenta in future pregnancies and attack the red blood cells of an Rh-positive baby, leading to severe complications.

  2. Haemolytic Disease of the Newborn (HDN): In future pregnancies, if the fetus is Rh-positive, the mother's anti-Rh antibodies can destroy the baby’s red blood cells, leading to anaemia, jaundice, heart failure, and even stillbirth if left untreated. HDN can range from mild to life-threatening.

  3. Severe Anaemia and Jaundice: Without management, Rh sensitization can cause severe anaemia in the fetus, which deprives tissues of oxygen. Newborns may develop severe jaundice due to the breakdown of red blood cells, which can lead to brain damage (kernicterus) if not treated properly.


Testing the Fetus’s Blood Type


With modern advances, it is possible to determine a fetus's Rh status using non-invasive prenatal testing (NIPT). This method analyzes the baby’s DNA from a sample of the mother’s blood. The test is available as early as 10 weeks into pregnancy and boasts an accuracy of over 99% for detecting the fetus's Rh factor.

“Rh incompatibility can be life-threatening if left unmanaged, but with current blood tests, we can detect fetal Rh status early on and take preventative measures”. -Dr. Miriam Greene

In conclusion


Understanding blood types, especially the Rh factor, is critical during pregnancy. Thanks to modern testing and the ability to provide a anti-D immunoglobulin, we can help ensure better outcomes for both mother and baby.

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