Blood Grouping
Dr.Ayesha Shaukat
• Universal Donar : O-ve and
• Universal Recipient AB+ve
Blood Grouping
• Transfusion is the transfer of blood or blood components from one
individual to another.
• Infusion is the introduction of fluid other than blood, for example:
saline solution or glucose solution.
• Blood Group is determined by the antigens (agglutinogens) on the
surface of RBCs.
• Antibodies (agglutinins) can bind to RBC antigens, resulting in
agglutination (clumping) or hemolysis (rupture) of RBCs
• Blood Groups: ABO and Rh
ABO Blood Typing
Blood Transfusion
• If the wrong blood type is used, the person’s
own immune system immediately attacks
the donor’s blood and causes clots and RBC
destruction that can lead to total kidney
failure and death.
No Agglutination Reaction
• A person with blood type A can receive blood from a
donor with blood type A.
• The anti-B antibodies in the recipient do not combine
with the type A antigens on the red blood cells of the
donor.
Agglutination Reaction
• A person with blood type B cannot receive blood
from a donor with blood type A.
• The anti-A antibodies in the recipient will
combine with the type B antigens on the red
blood cells of the donor.
Blood Replacement
• If severe blood loss occurs (>30%), the situation is life threatening and
requires that the lost blood be replaced.
• The infusion of blood requires that the person’s blood type be known.
Plasma and Blood Expanders
• In order to avoid blood reactions when blood loss is substantial and
there is no appropriate blood for transfusion, either plasma or
artificial materials can be used to replace volume.
• As long as the expanders have no RBC’s, there should be no
transfusion reaction.
• 0.9% saline
• Human serum albumin
• Altered physiological saline.
Rh factor
• Rh factor, also called Rhesus factor, is a type of
protein found on the outside of red blood cells.
The protein is genetically inherited (passed down
from your parents). If you have the protein, you
are Rh+positive. If you did not inherit the
protein, you are Rh-negative.
• It happens when the Rh factors in the mom's
and baby's blood don't match. If the Rh negative
mother has been sensitized to Rh positive blood,
her immune system will make antibodies to
attack her baby. When the antibodies enter your
baby's bloodstream, they will attack the red
blood cells, causing them to break down.
• Your rhesus status is fixed by your genes: If
you're rhesus positive (RhD positive), it means
that a protein (D antigen) is found on the surface
of your red blood cells. Most people are RhD
positive. If you're rhesus negative (RhD
negative), you do not have the D antigen on your
blood cells.
Development of the Fetus
• In the early developing fetus, the yolk sac, the liver and the spleen are
forming blood cells.
• By the seventh month of gestation and into adulthood, only the red
bone marrow makes blood cells unless something happens. Liver and
spleen can form blood cells in adults.
• The fetus makes a different hemoglobin from the adult. This form is
called hemoglobin F and it has a higher affinity for oxygen than does
the adult form.
Hemolytic Disease of the Newborn (HDN)
• HDN is the most common problem with Rh
incompatability
Development of HDN of the Newborn
• A small quantity of fetal blood leaks across the placenta into the maternal
blood stream.
• If the mother is Rh- and the baby is Rh+, the mother’s immune system begins
to produce anti-Rh antibodies.
• The mother’s antibodies cross the placenta during the subsequent pregnancy
into the fetal blood.
• If the second fetus is Rh+, the antigen-antibody reaction causes hemolysis of
fetal RBCs and it results in HDN.
Rh Factor
• Individual with Rh+ if
• Rh+ and Rh+
• Rh+ and Rh- (Rh+ is dominant over Rh-)
• Anti-Rh antibodies of the system are not normally present in the
plasma, but can be produced if an individual with
• Rh - is exposed to Rh+
Hemolytic disease of the newborn
• Causes
• During pregnancy, RBCs from the unborn baby can cross into the
mother's blood through the placenta. HDN occurs when the immune
system of the mother sees a baby's RBCs as foreign. Antibodies then
develop against the baby's RBCs. These antibodies attack the RBCs in
the baby's blood and cause them to break down too early.
• HDN may develop when a mother and her unborn baby have different
blood types. The types are based on small substances (antigens) on
the surface of the blood cells.
• There is more than one way in which the unborn baby's blood type may not
match the mother's.
• A, B, AB, and O are the 4 major blood group antigens or types. This is the
most common form of a mismatch. In most cases, this is not very severe.
• Rh is short for the "rhesus" antigen or blood type. People are either positive
or negative for this antigen. If the mother is Rh-negative and the baby in the
womb has Rh-positive cells, her antibodies to the Rh antigen can cross the
placenta and cause very severe anemia in the baby. It can be prevented in
most cases.
•
• If mother RhD negative and baby is RhD positive, and
you'll be offered an injection of anti-D
immunoglobulin within 72 hours of giving birth. The
injection will destroy any RhD positive blood cells that
may have crossed over into your bloodstream during
the delivery.
• Rhesus disease can largely be prevented by
having an injection of a medication called anti-D
immunoglobulin. This can help to avoid a
process known as sensitisation, which is when a
woman with RhD negative blood is exposed to
RhD positive blood and develops an immune
response to it.
If mother has received anti D injection at time of
Ist delivery, this causes neutralization of baby’s
Rh+ve RBCs, and immune system does not
activate to produce destruction.
