Rhesus disease in pregnancy

People who are rhesus negative are missing a compound called antigen D in their blood. During pregnancy and especially during labor, small amounts of the baby’s blood can be passed to the mother via the placenta. If the baby is rhesus positive, this will start a reaction in the mother who will start to produce antibodies to the D antigen. This is called rhesus disease or hemolytic disease of the newborn. It is a serious disease where the antibodies in the mother are starting to attack the unborn baby. This is uncommon in first pregnancies as the baby’s blood does not usually enter the mother’s bloodstream.

Prevention of Rhesus Disease

These days rhesus disease in pregnancy is uncommon and easily prevented. An injection of anti-D immunoglobulin is given the rhesus negative mothers, both during the pregnancy and within 72 hours of delivery if the baby is rhesus positive. Blood will be taken from the umbilical cord to confirm the baby’s blood type. The baby can only become rhesus positive if the father is rhesus positive. The anti-D injection prevents the mother from developing antibodies that attack the unborn baby and babies in subsequent pregnancies.

Blood Test to Check Antibodies

At the beginning of the pregnancy, the doctor will check if the woman is rhesus positive or rhesus negative. If she is rhesus negative, the doctor will usually perform a blood test to check for antibodies in her bloodstream. If antibodies are detected, the pregnancy will be monitored carefully to make sure that the level of antibodies does not become too high. In rare cases, where the incompatibility is severe, a series of blood transfusions (exchange transfusions) might be needed. This can be performed either in the uterus or when the baby has been delivered.

Symptoms and Treatment of Rhesus Disease in Newborn Babies

A symptom of rhesus disease in unborn babies is anemia. This can be monitored by ultrasound scans. When a baby is anemic, the blood will be thinner and flow more quickly. The mother should not experience any symptoms during or after the pregnancy. Symptoms of rhesus disease in newborn babies include anemia (lack of red blood cells) and jaundice. Babies with these conditions usually need to be admitted to the neonatal unit in the hospital for treatment and monitoring. Treatment usually includes phototherapy (treatment with light) and sometimes blood transfusions. If jaundice is left untreated, this can lead to learning difficulties, deafness, and blindness. Severe cases of rhesus disease can lead to brain damage, heart failure, fluid retention, swelling, and stillbirth (when a baby dies in the womb).