Rhesus isoimmunisation

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Have you ever been given an injection to your upper arm after delivering your first baby due to a problem with blood groups? Did you ever wonder why every obstetrician asks what your blood group is whenever you go see them? Did you ever wonder why they check the blood group first thing at the maternity clinic at the booking visit? This article will tell your why.

What is Rhesus isoimmunisation?

There are four major blood groups. They are A, B, AB and O. Each blood group is further subdivided into positive and negative according to the presence and the absence of the Rhesus factor.  Blood transfusion can only be done between compatible blood groups. Otherwise red blood cells clump together and give transfusion reactions, some of which are life threatening. 

Whenever incompatible blood groups come into contact, the body forms antibodies against foreign blood cells. Mothers may get exposed to foetal blood during pregnancy. If the foetal blood group is positive and maternal blood group is negative, mother forms antibodies against positive groups. This is known as Rhesus isoimmunisation. The new born baby is not affected by it. But the next baby is in trouble if its blood group is also positive. 

What are the causes of Rhesus isoimmunisation?

Reasons for Rhesus isoimmunisation are simply those which expose the Rhesus negative mother to the Rhesus positive blood of the foetus. Delivery is commonest time of exposure. During antenatal period miscarriages, induced abortions, ectopic pregnancies, trauma to the abdomen, invasive investigations like chorionic villous sampling and amniocentesis can result in maternal exposure to foetal blood. 

What are the effects of Rhesus isoimmunisation?

Rhesus isoimmunisation affects only the baby. Effects are seen only when standardized precautionary measures are not taken. They vary from mild to severe. Low haemoglobin level, yellowish discolouration of eyes, skin, heart failure, respiratory distress and swelling of the body represent a few key conditions upon the disease spectrum. During childhood the affected babies may be slow to develop cognitive skills, have movement disorders, hearing loss and seizure disorders. 

What should you do?

Most important thing to understand is that Rhesus isoimmunisation is 100% preventable. You cannot detect it at home. Just make sure that you receive the injection after any potential procedures and delivery. This injection should be given within 72 hours. You need to know your blood group. If you have a Rhesus negative blood group be extra careful. Always inform healthcare professionals about your blood group.

Can it be treated effectively?

If by any chance Rhesus isoimmunisation does occur, the treatment regimen should be guided by the severity of symptoms. Mild disease usually needs only proper hydration and phototherapy. Severe disease states like hydrops foetalis (swelling of the body) may need blood transfusion while inside the uterus, early induction of labour, exchange transfusion to remove all the maternal antibodies against the foetal positive blood, heart failure and fluid management. Extreme levels of bilirubin can cause Kernicterus. This can be treated with phototherapy and exchange transfusion. 

By: Dr T.M.S.Sameera B. Madugalle MBBS (COL)

 

ඔබට ඇති වෛද්‍ය ගැටළු අසන්න මෙහි ක්ලික් කරන්න, Ask a Doctor | වෛද්‍යවරයාගෙන් අසන්න

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මෙම ලිපිය ඔබට ප්‍රයෝජනවත් වුනානම් හෝ ඔබේ මිතුරියකට ප්‍රයෝජනවත් වේ යයි සිතනවානම්, කරුණාකර පහත ඇති "recommend" ක්ලික් කිරීමෙන් එය බෙදා හදා ගැනීමට අමතක කරන්න එපා. තවද, මෙම ලිපිය පිළිබඳව ඔබේ අදහස්, යෝජනා සහ අනෙකුත් මවුවරුන්/කාන්තාවන් හට ප්‍රයෝජනවත් වන ඔබේ අත්දැකීම් පහත ලියා තැබීමටද අප ආරාධනා කරමු. ස්තුතියි!

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