Pregnancy awareness: Blood type incompatibility and disability
One of the first tests a pregnant woman should expect is a test to determine her blood-type. This test checks her blood group and Rhesus factor. A mother’s Rhesus or Rh factor may play a role in her baby’s health and future pregnancies, so it’s important to know this information early on.
- What do I need to know about blood types?
All people belong to one of four blood groups: A, B, AB, or O. A person is also classified as either Rh-positive or Rh-negative. A Rhesus factor is a protein found on some red blood cells. Not everyone carries this protein, though most do. They are Rh-positive. People who don’t carry the protein are Rh-negative.
There are therefore eight different main blood types. The eight main types are A+, A-, AB+, AB-, B+, B-, O+, and O-.
Not all blood types are compatible with each other. A baby’s blood type can be incompatible with that of his or her mother. Rh incompatibility occurs when a mother has Rh-negative blood and the baby has Rh-positive blood.
- What if parents don’t have the same Rhesus factor?
When a mother-to-be and father-to-be do not both have the same (positive or negative) Rh factor, it can result in Rh incompatibility.
Rh incompatibility usually isn’t a problem if it’s the mother’s first pregnancy. That’s because the baby’s blood does not normally enter the mother’s circulatory system during the pregnancy.
During the birth, though, the mother’s and baby’s blood can mix. If this happens, the mother’s body recognizes the Rh protein as a foreign substance. It then might begin making antibodies (proteins that act as protectors if foreign cells enter the body) against the Rh protein.
- When is a baby at risk?
Rh antibodies are harmless until the mother’s second or later pregnancies. If she is ever carrying another Rh-positive child, her Rh antibodies will recognize the Rh proteins on the surface of the baby’s blood cells as foreign. Her antibodies will pass into the baby’s bloodstream and attack those cells.
This can make the baby’s red blood cells swell and rupture. This is known as haemolytic or Rhesus disease of the newborn. It can make a baby’s blood count get very low.
Rhesus disease doesn’t harm the mother, but it can cause the baby to become anaemic and develop jaundice. If rhesus disease is left untreated, severe cases can lead to stillbirth. In other cases, it could lead to brain damage, learning difficulties, deafness and blindness.
- How is Rhesus incompatibility treated?
If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin injections during her first pregnancy. She’ll get:
- The first shot around the 28th week of pregnancy; and
- The second shot within 72 hours of giving birth.
Rh immune-globulin acts like a vaccine. It prevents the mother’s body from making any Rh antibodies that could cause serious health problems in the newborn or affect a future pregnancy. A woman also might get a dose of Rh immune-globulin if she has a miscarriage, an amniocentesis, or any bleeding during pregnancy.
In rare cases, if the incompatibility is severe and a baby is in danger, the baby can get special blood transfusions called exchange transfusions either before birth (intrauterine fetal transfusions) or after delivery. Exchange transfusions replace the baby’s blood with blood with Rh-negative blood cells. This stabilizes the level of red blood cells and minimizes damage from Rh antibodies already in the baby’s bloodstream.
- What are the risks if it is not diagnosed or treated in time?
A mother may have difficulty with future pregnancies, resulting in miscarriages.
If the incompatibility is not detected, a newborn can develop anemia or severe jaundice leading to death, brain damage, and other disabilities, including blindness and deafness. Neurodevelopmental impairment and adult cardiovascular disease are long-term complications that have been reported in association with severe fetal anaemia.
While it can have serious consequences, jaundice in newborns is common and treatable; medical attention is necessary at the first sign of yellowish discoloration in the skin or eyes. Jaundice can be treated through hydration and phototherapy. Biliblankets and other phototherapy equipment help the infant’s body expel bilirubin, the cause of jaundice. It is important that jaundice (due to hyperbilirubinemia) be treated to prevent disability.
Medical negligence attorneys at your service
If you suspect that you received substandard or negligent care during your pregnancy and you or your baby has suffered harm as a result thereof, contact Paul du Plessis Attorneys for advice by visiting our website, email paul@pauldup.co.za or phone us at 012 809 1588.
For more information visit these sources:
https://sanbs.org.za/blood-types/
https://www.cerebralpalsy.org/about-cerebral-palsy/risk-factors/blood-incompatibility
https://kidshealth.org/Levine/en/parents/rh.html
https://www.sciencedirect.com/science/article/abs/pii/S1473050220302640