You are on page 1of 15

RH INCOMPATIBILITY

SWATILEKHA DAS
(RN,MSN)
INTRODUCTION
Rh incompatibility is a condition that
occurs during pregnancy if a woman
has Rh-negative blood and her baby
has Rh-positive blood.
DEFINITION
Rh disease (also known rhesus
isoimmunisation, as Rh (D)
incompatibility, rhesus
disease,
disease, RhD hemolytic
rhesus
disease of the newborn, rhesus D hemolytic
disease of the newborn or RhD HDN) is a type
of hemolytic disease of the newborn (HDN).

The disease ranges from mild to severe, and


typically occurs only in some second or
subsequent pregnancies of Rh negative women
where the fetus's father is Rh positive, leading to
a Rh+ pregnancy.
CAUSES
A difference in blood type between a
pregnant woman and her baby causes
Rh incompatibility. The condition occurs
if a woman is Rh-negative and her baby
is Rh-positive.
RISK FACTORS
This may have happened during:
 An earlier pregnancy (usually during delivery).

 An ectopic pregnancy, a miscarriage, or an


induced abortion. (An ectopic pregnancy is a
pregnancy that starts outside of the uterus, or
womb.)

A mismatched blood transfusion or blood and


marrow stem cell transplant.

 An injection or puncture with a needle or other


object containing Rh-positive blood.
PATHOPHYSIOLOGY
Rh Incompatibility in Pregnancy-

1st Pregnancy

Father (RhD+) first newborn(RhD+)Safe


Mother
But mother (RhD-) is now
Fetal –maternal blood sensitized to RhD antigen.
(RhD-)
transfer during labor
Fetus (RhD+)
2nd Pregnancy-
Father (RhD+) Rapid production of IgG
anti-D by mother
Mother
Repeat encounter with
fetal RhD antigen
(RhD-)

Fetus (RhD+)
Maternal IgG anti-D
crosses placenta.
Severe
Incresed billirubin. Mild case
CNS Mild anemia,
damage(kernict jaundice
erus), death.

IgG anti-D attaches to


Fetal or newborn Hemolytic fetal BBCs & marks them
Anemia. for destruction.

Note: If mother is sensitized to RhD antigen prior to first pregnancy, then first fetus will
be affected.
SIGNS & SYMPTOMS OF RH
INCOMPATIBILITY
It can cause symptoms ranging from very mild to
fatal.
Mildest form – Rh Incompatibility:
1. Hemolysis
2. Jaundice
3. Total body swelling
4. Respiratory distress
5. Circulatory collapse
6. Kernicterus
7. It occurs several days after delivery and is
characterized initially by-
A. Poor feeding
B. Decreased activity
DIAGNOSTIC TESTS
MATERNAL BLOOD-
The Kleihauer-betke test or
flow cytometry
Indirect coombs test

FETAL BLOOD-
• The direct Coombs test
• Blood count
• Billirubin(direct & indirect)
TREATMENT
Rh incompatibility is treated with a medicine called Rh immunoglobulin.
Treatment for a baby who has hemolytic anemia will vary based on the
severity of the condition.

Goals of Treatment
 The goals of treating Rh incompatibility are to ensure that baby is healthy
and to lower mother’s risk for the condition in future pregnancies.

Treatment for Rh Incompatibility


 If Rh incompatibility is diagnosed during pregnancy, mother will receive Rh
immunoglobulin in seventh month of pregnancy and again within 72 hours
of delivery.

 Mother also may receive Rh immunoglobulin if the risk of blood transfer


between mother and the baby is high (for example, a miscarriage, ectopic
pregnancy, or bleeding during pregnancy).
 Rh immunoglobulin contains Rh antibodies that attach to
the Rh-positive blood cells in mother’s blood. When this
happens, mother’s body doesn't react to the baby's Rh-
positive cells as a foreign substance. As a result, mother’s
body doesn't make Rh antibodies. Rh immunoglobulin
must be given at the correct times to work properly.

 Once mother have formed Rh antibodies, the medicine will


no longer help. That's why a woman who has Rh-negative
blood must be treated with the medicine with each
pregnancy or any other event that allows her blood to mix
with Rh-positive blood.

 Rh immunoglobulin is injected into the muscle of arm or


buttock. Side effects may include soreness at the injection
site and a slight fever. The medicine also may be injected
into a vein.
SCREENING & PREVENTION
 Rh incompatibility can be prevented with Rh immunoglobulin,
as long as the medicine is given at the correct times. Once
mother has formed Rh antibodies, the medicine will no longer
help.

 Thus, a woman who has Rh-negative blood must be treated


with Rh immunoglobulin during and after each pregnancy or
after any other event that allows her blood to mix with Rh-
positive blood.

 Early prenatal care also can help prevent some of the


problems linked to Rh incompatibility. For example, doctor
can find out early whether mother is at risk for the condition.

 Ifmother is at risk, doctor can closely monitor pregnancy. He


or she will watch for signs of hemolytic anemia in baby and
provided treatment as needed.
PLEASE LIKE , SHARE
AND FOLLOW

You might also like