HEMORRHAGIC (RH) DISEASE OF THE NEW BORN

 

Introduction: Rh disease of the newborn may also be called erythroblastosis fetalis and is the result of an Rh incompatibility between mother and fetus. During a normal pregnancy, maternal blood and fetal blood do not mix in the placenta. However, during delivery of the placenta, some fetal blood may enter maternal circulation. If the woman is Rh negative and her baby is Rh positive, this exposes the woman to Rh-positive Red blood cells (RBCs). Red blood cell: Blood transfusion protocols  

THE RESPONSES OF MATERNAL AUTOTRANSFUSION:  In response, her immune system will now produce anti-Rh antibodies following this first delivery. In a subsequent pregnancy, these maternal antibodies will cross the placenta and enter fetalcirculation. If this next fetus is also Rh positive, the maternal antibodies will cause destruction (hemolysis) of the fetal RBCs. In severe cases this may result in the death of the fetus. 

In less severe cases, the baby will be born anemic and jaundiced from the loss of RBCs.  Such an infant may require a gradual exchange transfusion to remove the blood with the maternal antibodies and replace it with Rh-negative blood. The baby will continue to produce its own Rh-positive RBCs, which will not be destroyed once the maternal antibodies have been removed. Much better than treatment, however, is prevention. 

PREVENTION:  If an Rh-negative woman delivers an Rh positive baby, she should be given RhoGAM within 72 hours after delivery. RhoGAM is an anti-Rh antibody that will destroy any fetal RBCs that have entered the mother’s circulation before her immune system can respond and produce antibodies. The RhoGAM antibodies themselves break down within a few months. The woman’s next pregnancy will be like the first, as if she had never been exposed to Rh-positive RBCs.

RELATED;

1. IMMUNITY  

2. IMMUNOGLOBULINS  

3.  DRUG CATEGORY IN RELATION TO PREGNANCY

4. THE HUMAN RED BLOOD CELLS

5.  FETAL CIRCULATION

6.  JAUNDICE