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Rhesus Factor In Pregnancy

Rhesus (Rh) factor is an inherited trait that refers to a specific protein found on the surface of the red blood cells. If your blood has the protein, you are Rh positive which is the most common Rh factor. If your blood lacks the protein, you are Rh negative
In addition to the blood group (A, B, O, AB), the Rh factor is written as either positive (present) or negative (absent). Most people are Rh positive. This factor does not affect your health except during pregnancy. Each of the four blood types is additionally classified according to the presence of another protein on the surface of RBCs that indicates the Rh factor. If you carry this protein, you are Rh positive. If you don’t carry the protein, you are Rh negative.

Health care providers basically recommend a Rh factor test during first prenatal visit, which is a basic blood test that indicates whether a pregnant  woman Rh positive or Rh negative, to determine blood type and Rh factor to know this information early in pregnancy.
According to a medical practitioner, Dr Suleiman Adebayo of Reboth clinic, Kaduna, Rh incompatibility usually is not a problem if it is the mother’s first pregnancy because, unless there’s some sort of abnormality, the fetus’s blood does not normally enter the mother’s circulatory system during the course of the pregnancy.
He added that, if you experience any bleeding during pregnancy or if you have an amniocentesis, miscarriage, ectopic pregnancy or termination, you need to make your primary medical care aware of this as soon as possible, as these may all pose opportunities for the blood of the fetus to mix with that of the mother’s and it will be unclear in most of those cases as to which blood group the baby belonged to. If none of these things happen, in a normal pregnancy, you will not need ‘routine’ anti-D injections until after the birth.
Research shows that, some obstetricians routinely give Rh- women Anti-D injections without any blood tests to detect antibodies. However you might like to ask your doctor if this is really going to be effective or worthwhile if you have had no indication to suggest you have been bleeding. Not only is the shot of Anti-D a blood product which involves risks in itself, it increases the chances that those routine injections usually 2-3 will be given to you within 72 hours of possible bleeding, as required after possible exposure which there has been no indication of bleeding. Your baby’s circulation is completely separate to yours so in a healthy pregnancy, the chance of the blood mixing is very, very slim.
About 85% of people are Rh positive, but if a woman who is Rh negative and a man who is Rh positive conceive a baby, there is the potential for a baby to have a health problem. The baby growing inside the Rh-negative mother may have Rh-positive blood, inherited from the father. Approximately half of the children born to an Rh-negative mother and Rh-positive father will be Rh positive.
A woman is at risk when she has a negative Rh factor and her partner has a positive Rh factor. This combination can produce a child who is Rh positive. While the mother’s and baby’s blood systems are separate there are times when the blood from the baby can enter into the mother’s system. This can cause the mother to create antibodies against the Rh factor, thus treating an Rh positive baby like an intruder in her body. If this happens the mother is said to be sensitized.
A sensitized mother’s body will make antibodies. These antibodies will then attack an Rh positive baby’s blood, causing it to break down the red blood cells of the baby and anemia will develop. In severe cases this hemolytic disease can cause illness, brain damage and even death.
However, the good news is since a small number of un-sensitized women may have problems during the end of pregnancy, many practitioners recommend that she be given an injection of RhIg (also known as Rhogam) at 28 weeks gestation, to prevent the few cases of sensitization that occur at the end of pregnancy. Each dose of RhIg lasts about 12 weeks. The mother will also be given RhIg within 72 hours of birth if the child is Rh positive. The baby’s blood type can be determined easily after birth by cord blood samples.
Experts advice that when Rhogam is given, there should be an identification card to be carried around which indicates that you have been given Rhogam, hence, If your doctor or midwife doesn’t offer an ID card, be sure to ask about this safety measure..
Rhogam may also be given after an amniocentesis, miscarriage, abortion or postpartum sterilization (tubal ligation). This is because there is a small chance of blood contamination and potential sensitization even after these procedures or occurrences. It is not common knowledge that even if a pregnancy is not full term it can still lead to a woman being sensitized.
If you have questions about the Rh factor or whether or not you are in this group of women, do not hesitate to ask your doctor or midwife for the results of your blood work.
FACTS ABOUT RH FACTOR
•      An Rh-positive mom will not have Rh disease, regardless of her partner’s Rh status.
•      An Rh-negative mom and an Rh-negative partner will not have result in Rh disease.
•      An Rh-negative mom and an Rh-positive partner can result in Rh disease.
SYMPTOMS OF RH FACTOR INCOMPATIBILITY
•      Pale skin and mucous membranes (lining of the cheeks and gums)
•      Limp and sleepy
•      Jaundice (yellowing of the skin and eyes)
•      Difficulty breathing
•      Swelling in his face, arms, and legs

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