Example Main Post

Claimed Topic

Incompatibility between mother and fetus in Rh blood type: First vs Second pregnancy

Research:

Everyone has a different blood type. Every person has one of the four ABO blood types

A, B, AB, or O. One’s blood type can be determined by the antigens in that person’s blood cells.

Rh factor is a type of protein that is on the surface of the red blood cells. Rh blood group is

known for the rhesus monkey, which the Rh antigens were first discovered in 1940 (Saladin,

2020). Rh antigens have three common antigens which are C, D, and E. Antigen D is the most

reactive antigen. If a person have the Rh antigen, he or she is considered Rh positive (Rh +)

(Saladin, 2020). If he or she lacks the antigen, then that person is considered Rh negative (Rh-)

(Pegoraro et al, 2020). If a person has a mismatched blood type with his or her second fetus,

when the mother is Rh- and the fetus is Rh+, significant health issues can occur such as death

from anemia. If the mother is Rh+ and the first baby is either Rh+ or Rh-, no problems will

occur. Why is the first pregnancy not an issue and the second pregnancy a cause for concern?

The mother will not be sensitized.

During a woman’s first pregnancy, if she is +Rh- and the baby is Rh, there are generally

no problems. The concern is the fetal blood mixing with the mother’s blood, this most often

occurs during delivery (Rh factor blood test, 2018). If this happens the mother is exposed to the

Rh + factor and will produce the Rh antibodies which will attack any Rh- fetuses in subsequent

pregnancies. Rh- mothers are given an injection of RhoGAM, antibodies to the Rh factor. These

antibodies bind to the Rh+ fetal RBCs and ‘hide’ them from the mother’s immune system and

prevent antibodies to the Rh factor from forming. The RhoGam shot is needed each time the

mother is pregnant with an Rh+ fetus. (Saladin, 2020).

During a woman’s second pregnancy, her OB/GYN will test her for the RH factor again

to do an antibody screen. Usually, this test is around Week 28. If the mother becomes pregnant

with a Rh+fetus, the mother’s antibodies can pass through the placenta and agglutinate the fetal

erythrocytes (Saladin, 2020). If this occurs, the children are born with a condition called

hemolytic anemia (Saladin, 2020). Why should we care? Studies stated that 50% of women

around the world are not fully educated about this topic and did not receive immunoprophylaxis

due to a lack of awareness (Pegoraro et al., 2020). It can mean the difference between life and

death.

W/C 432

Critical Thinking:

When they find out they are pregnant, many women are elated. But there are issues that

every woman should be aware of. One of the important issues that are addressed in the first

trimester of pregnancy is the woman’s blood type. One way I remember Rh is MRh+ BRh+ or

BRh- = OK. (M is for Mom and B is for Baby). MRh- BRh+ =Bad. Knowing one’s RH blood

type is extremely critical during a pregnancy for the health of mom and baby. If the woman has

RH incompatibility with her fetus, there are treatments available, and both mom and fetus can

have a healthy pregnancy and birth. Mom can focus more on the important things such as

welcoming a healthy baby. Personally, I am currently 12 weeks pregnant with my second child

and will be going for my blood test tomorrow. I was never fully educated on Rh incompatibility

as many others.

WC 153

References

Pegoraro, V., Urbinati, D., Visser, G. H. A., Di Renzo, G. C., Zipursky, A., Stotler, B. A., &

Spitalnik, S. L. (2020). Hemolytic disease of the fetus and newborn due to Rh(D)

incompatibility: A preventable disease that still produces significant morbidity and

mortality in children. PLOS ONE, 15(7), eO235807.

http://dx.doi.org/10.1371/journal.pone.02358

Rh Blood Test – Mayo Clinic. (2018). Retrieved from https://www.mayoclinic.org/test-

procedures/h-factor/about/pac-20394960

Saladin, K. (2020). Anatomy & Physiology: The Unit of Form and Function. (9th ed.). McGraw-

Hill Education

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