Awareness during pregnancy on Rh screening and prophylaxis

Awareness during pregnancy on Rh screening and prophylaxis
Rh-induced haemolytic disease of the newborn (RhD HDN) which is otherwise known as Rh(D) disease, Rh disease, isoimmunisation, Rh incompatibility or erythroblastosis foetalis is a condition seen in the newborns or infants as a result of incompatibility between the blood type of a mother and her baby. The incompatibility occurs during pregnancy particularly in the woman who possesses Rh-negative blood with a baby having Rh-positive blood. The rate of incidence and complication of Rh incompatibility varies in different parts of the world; although, this disease is preventable with Rh immunoglobulin (RhIg or Anti-D), it is still acting as one of the major reasons of complications, abortions and infants death in many parts of the developing world. The major reason behind this is the high level of ignorance about the Rh factor among the pregnant women as they do not encounter any symptoms during pregnancy; in addition, non-immunization, under-immunization and sometimes false Rh typing could also be responsible for it. Rh factor (Rh D antigen) is a specific protein found on the red blood cells and its presence or absence denotes that, the blood is positive or negative (e.g. A +ve , A -ve, B +ve, B -ve, etc.). Mostly, an Rh-negative mother and an Rh-positive father conceive an Rh-positive baby. During first pregnancy, when the Rh-negative mother’s blood encounters Rh-positive baby’s RBCs (90% during child birth), it produces antibodies (IgM) against them considering them to be foreign. Usually the first baby escapes against these antibodies and during subsequent pregnancies, a repeat encounter with Rh-positive baby’s RBCs stimulates the rapid production of antibodies (IgG anti-D) that get transported across the placenta into the baby’s blood stream and result in the destruction of foetal red blood cells. This causes Rh disease in the newborns and to prevent this, the mothers must get aware of Rh screening and prophylaxis.
To prevent Rh disease, following must be practised during pregnancy:
  • Mothers must know their Rhesus status through simple blood typing.
  • If mothers are Rh-negative, then fathers should compulsorily get checked for their Rh factor compatibility.
  • Mothers must get early prenatal care.
  • Rh-negative mothers must get treated with RhIg after any situation in which the foetal red blood cells can mix with her blood, including early pregnancy, miscarriage, ectopic pregnancy, induced abortion, amniocentesis, chorionic villus sampling (CVS), abdominal trauma, external cephalic version, injury, mismatched blood transfusion and trauma (Note: RhIg becomes ineffective once Rh alloimmunization (sensitization due to exposure to Rh-positive blood) has occurred.
  • Rh-negative mothers must get determined their baby’s blood type by performing a genetic test on mother’s plasma if affordable.
  • Rh-negative mothers must get their Rh antibodies’ level tested one or more times if Rh incompatibility is known or suspected.
  • Rh-negative mothers must undergo Doppler ultrasound to get checked the severity of their baby’s hemolytic anaemia.
  • Proper diagnosis of hemolytic anaemia must be carried out in babies suspected with Rh incompatibility to provide early and specific treatment.
  • It is always better to prevent Rh disease instead of intervening it with expensive and inaccessible procedures. All that is required to prevent this disease is proper awareness towards Rh factor and its complications during pregnancy. Remember nothing in this world is more dangerous than ignorance.
    How to cite this article:
    Hameedunissa Begum Shariff. Awareness during pregnancy on Rh screening and prophylaxis . BioLim O-Media. 14 September, 2015. 3(7).
    Available from: http://archive.biolim.org/omedia/read/BOMA0087.