Rh Incompatibility & Sensitization
When Rh-negative mother develops antibodies against Rh-positive baby's blood cells.
Affects: 15% of population is Rh negative; incompatibility much rarer with RhoGAM
Overview
Rh incompatibility occurs when an Rh-negative mother is pregnant with an Rh-positive baby. If the baby's blood crosses into the mother's bloodstream, her immune system may produce antibodies against the Rh factor.
The first pregnancy is usually unaffected, but antibodies can attack Rh-positive babies in future pregnancies, causing anemia and other serious problems. This is called hemolytic disease of the newborn.
RhoGAM (Rh immune globulin) injections prevent sensitization by destroying fetal blood cells before the mother's immune system responds. This has made Rh disease largely preventable.
🩺 Symptoms
- •Mother: Usually no symptoms
- •Baby: Anemia
- •Baby: Jaundice
- •Baby: Enlarged liver and spleen
- •Baby: Heart failure (severe cases)
- •Baby: Hydrops fetalis (most severe)
- •Detected through blood tests
🔍 Causes
- →Rh-negative mother pregnant with Rh-positive baby
- →Baby's blood enters mother's circulation
- →Mother's immune system creates antibodies
- →Antibodies cross placenta in subsequent pregnancies
- →Attack baby's red blood cells
⚠️ Risk Factors
- •Being Rh-negative
- •Father is Rh-positive
- •Events that mix maternal and fetal blood:
- •- Miscarriage, abortion, ectopic pregnancy
- •- Amniocentesis or CVS
- •- Placental abruption
- •- Trauma to abdomen
- •- External cephalic version
- •- Delivery
- •Previous pregnancy without RhoGAM
🔬 Diagnosis
- →Blood type and Rh testing at first prenatal visit
- →Antibody screening
- →Father's blood type testing
- →If sensitized: Regular antibody titer levels
- →Fetal monitoring with ultrasounds
- →Middle cerebral artery Doppler for anemia
- →Amniocentesis to check bilirubin levels
💊 Treatment
- ✓Prevention: RhoGAM at 28 weeks
- ✓RhoGAM after delivery if baby is Rh-positive
- ✓RhoGAM after miscarriage, amniocentesis, trauma, etc.
- ✓If sensitized: Close monitoring of antibody levels
- ✓Fetal ultrasounds to check for anemia
- ✓Intrauterine blood transfusion if severe
- ✓Early delivery if needed
- ✓Newborn treatment: Phototherapy, exchange transfusion
🛡️ Prevention
- →RhoGAM injection at 28 weeks for Rh-negative mothers
- →RhoGAM within 72 hours after delivery of Rh-positive baby
- →RhoGAM after any event that may mix blood
- →Prevents over 99% of sensitization
- →Cannot reverse sensitization once it occurs
⚠️ Potential Complications
- !Mild to severe anemia in baby
- !Kernicterus (brain damage from severe jaundice)
- !Heart failure
- !Hydrops fetalis (severe fluid buildup)
- !Stillbirth
- !Need for blood transfusions
- !Developmental problems
- !Death (if untreated)
🚨 When to Call Your Doctor
Contact your healthcare provider immediately if you experience:
- ⚠Decreased fetal movement
- ⚠Any trauma to abdomen
- ⚠Vaginal bleeding
- ⚠After any procedure
- ⚠If you're Rh-negative and haven't received RhoGAM
- ⚠Concerns about previous sensitization
Related Conditions
This information is for educational purposes and should not replace medical advice. Always consult your healthcare provider for personalized guidance.