What is Rh Incompatibility?
Rh incompatibility is a common medical condition mostly experienced by expectant women. Rh incompatibility does not affect a person's health condition, but it can rise to problems during pregnancy.
Rh incompatibility condition has been a major condition suffered by most pregnant women worldwide during their pregnancy period.
When a pregnant woman is said to be suffering from the condition of Rh incompatibility it means that she has Rh-factor in her blood. It is not necessarily for a woman to be Rh positive for the infant in the womb to be Rh- positive. Some expectant women can be Rh negative and can give birth to a child testing Rh positive.
Significant protein found on red blood cells can develop to Rh incompatibility. People with Rh factor are likely to have inherited it from their parents since the condition is genetically inherited from specific genes carried by the woman.
Presence of Rh factor in a person's blood means that the person is Rh positive while absence of Rh factor shows that the person is Rh negative.
Causes of Rh Incompatibility
Rh incompatibility is caused between the period of pregnancy and delivery time. A mother who is Rh negative can get infected with the Rh factor if the new born is Rh positive during pregnancy or delivery time when the baby's blood crosses into the mother's blood stream.
This causes a reaction in the mother's body and it immediately starts to create antibodies made up of proteins which go against the infant's Rh positive blood.
Exposure of a pregnant woman to Rh-positive fetal red blood cells who is Rh negative can acquire Rh factor during abortion or any type of trauma.
Blood transfusion can also lead to acquiring of Rh factor. The following are causes that can lead to development of Rh incompatibility;
- Abruption placenta
- Ectopic pregnancy
- Trauma to the abdomen or pelvis
- Experience of regular abortion
- Lack of prenatal care during pregnancy.
The following diagram shows the origin and development of Rh incompatibility.
Signs and Symptoms of Rh Incompatibility
Symptoms of Rh incompatibility can show in the following ways:
There are clinical symptoms which can show when hemolytic disease rises when the mothers' antibodies try to attack the red blood cell (RBCs) of the infant.
Destroying of the red blood cell leads to rising level of bilirubin in the infant's body which can result to the impairment of the liver, thus leading to abnormal functionality.
The following are the signs of Rh incompatibility that results from the high level of bilirubin in babies;
- Lethargy, these means having extreme fatigue or drowsiness or prolonged sleep patterns.
- The baby can be born with the yellowish color at the white part of both eyes.
- Low muscle tone
- It is recommended for the baby to undergo medical care or treatment to cure the condition.
Diagnosis of Rh Incompatibility
It is advisable for all pregnant women to get tested for Rh incompatibility during the period of pregnancy in order to avoid complication that are later suffered by the infant.
The following are the various methods of testing an Rh negative woman;
- Point of care blood test that determines the Rh status is the first test to diagnose Rh incompatibility.
- Indirect coombs test used to screen women for igG antibodies
- Kleihauer-Betke test used in quantitative measurement of the newborn red blood cells in the blood
- Rosete screening test that is used to detect the presence of alloimmunization due to a fetomaternal hemorrhage
- One should also obtain maternal Rh antibody titers for future follow up care
Rh Incompatibility Diagnosis for Infants
- The first diagnosis for Rh incompatibility is to take the blood count to check hemoglobin level of the newborn and the Platelet
- Confirmation of an existing immune mediated hemolytic anemia of the fetus or neonate through direct combs test
- Going through amniocentesis to evaluate fetal status in Rh sensitization.
Treatment for Rh Incompatibility
In this case the main aim in the treatment of Rh incompatibility is to prevent Rh factor entering the blood in women during pregnancy time. There are two approaches in treatment of the condition namely:
Antenatal Approach to Treat Rh Incompatibility
- Detecting signs of feta anemia using Doppler and ultrasound to examine the presence of hydrops fetalis
- Intrauterine blood transfusion
- Early delivery of the new born after about the 36 weeks' age of gestation
- Quantitative analysis of maternal anti-RHD antibodies.
Postnatal Approach to Treat Rh Incompatibility
A woman should get the first shot of immune- globulin on the 28th week of pregnancy while the second should be given after delivery within 72-hour period hour period for treating Rh incompatibility. This is done when the woman is at risk of having incompatibility in the future. It is usually done during the first pregnancy to avoid the condition in future pregnancies. Phototherapy can also be used to resolve neonatal jaundice in mild cases.
Complications of Rh Incompatibility
Rh incompatibility condition rarely causes complication during the first pregnancy but it mostly affects women in their future pregnancies. When Rh antibodies are formed they bring about fetal risk in future.
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