Summary about Disease
Blood group incompatibility occurs when the mother and fetus have different blood types, and the mother's immune system produces antibodies against the fetus's red blood cells. The most common form involves Rh incompatibility (specifically RhD), where the mother is Rh-negative and the fetus is Rh-positive. It can also involve ABO incompatibility, which is usually milder. This antibody reaction can lead to the destruction of fetal red blood cells (hemolysis), causing anemia and potentially severe complications for the fetus or newborn.
Symptoms
Fetus/Newborn: Anemia, jaundice (yellowing of the skin and eyes), enlarged liver and spleen, fluid buildup (hydrops fetalis) in severe cases.
Mother: Usually asymptomatic, but the presence of anti-Rh antibodies can be detected through blood tests.
Causes
Rh Incompatibility: An Rh-negative mother carrying an Rh-positive fetus develops antibodies against the Rh factor. This typically occurs during a previous pregnancy with an Rh-positive fetus, delivery, miscarriage, abortion, or certain medical procedures where fetal blood may enter the mother's circulation.
ABO Incompatibility: Occurs when the mother has blood type O and the fetus has blood type A, B, or AB. Maternal anti-A or anti-B antibodies cross the placenta and attack fetal red blood cells.
Medicine Used
4. Medicine used
Rho(D) Immune Globulin (RhoGAM): Given to Rh-negative mothers during pregnancy and after delivery to prevent the development of Rh antibodies.
Intravenous Immunoglobulin (IVIG): May be used in severe cases to reduce the level of maternal antibodies.
Phototherapy: Used to treat jaundice in newborns by breaking down bilirubin.
Exchange Transfusion: In severe cases, the newborn's blood is replaced with donor blood to remove bilirubin and antibodies.
Intrauterine Transfusion: If the fetus is severely anemic, blood transfusions may be given while the fetus is still in the womb.
Is Communicable
Blood group incompatibility is not communicable. It is an immune response triggered by the mixing of fetal and maternal blood due to differing blood types and is not caused by an infectious agent.
Precautions
Rh-negative mothers: Receive RhoGAM injections during pregnancy and after delivery if the baby is Rh-positive.
Blood type testing: Routine blood type testing of pregnant women.
Monitoring: Monitor antibody levels in Rh-negative mothers during pregnancy.
Early intervention: Manage jaundice and anemia in newborns promptly.
Prenatal care: Regular prenatal care to detect and manage potential complications.
How long does an outbreak last?
There is no "outbreak" associated with blood group incompatibility. The duration of the effects depends on the severity of the incompatibility and the treatment provided. Jaundice in newborns typically resolves within a few days to weeks with treatment. The risk to future pregnancies can be mitigated with proper management and RhoGAM administration.
How is it diagnosed?
Maternal Blood Tests: Blood type and Rh factor determination, antibody screening (Indirect Coombs test) to detect the presence of anti-Rh or anti-A/B antibodies.
Fetal Monitoring: Ultrasound to detect signs of hydrops fetalis.
Amniocentesis: Rarely used to assess fetal anemia in Rh incompatibility.
Newborn Blood Tests: Blood type and Rh factor, Direct Coombs test (to detect antibodies attached to the baby's red blood cells), bilirubin levels, hemoglobin levels.
Timeline of Symptoms
9. Timeline of symptoms
During Pregnancy (Severe Rh incompatibility, untreated): Fetal anemia develops over time, potentially leading to hydrops fetalis in the second or third trimester.
At Birth/Shortly After: Jaundice usually appears within the first 24-48 hours after birth. Anemia may be present at birth or develop shortly after.
ABO incompatibility: Milder jaundice, appearing in the first 24 hours.
Important Considerations
RhoGAM is highly effective in preventing Rh sensitization.
ABO incompatibility is usually milder than Rh incompatibility and often doesn't require treatment beyond phototherapy.
Early detection and management are crucial to prevent severe complications.
With appropriate prenatal care and treatment, the prognosis for babies with blood group incompatibility is generally good.
If a mother has already developed Rh antibodies, RhoGAM is no longer effective.