Written by Balogun Zainab Olabisi Medically Reviewed by Dr. Tunde Olagunju
Apart from the main blood group type in the body( I.e the A, B, and O) we still have to confirm our antigen status, (which presents the positivity or negativity of the ABO group)
The positive or negative of the ABO group is the Rhesus factor, Which means if you are O(+) or B(+) you are carrying the Rhesus factor Rh(+), But if you are O(-) or B(-) you are not carrying Rhesus factor, Therefore will say you are Rh(-).
Rhesus (RH) factor is also known as hemolytic disease of the fetus and newborn.
Most times the antigen status is either negative or positive, the status of an individual is determined and inherited from both parents.
They are two types of rhesus factor, The Rh(-) negative and Rhesus positive(D)
Rhesus is a type of protein found outside the red blood cell.
Rhesus factor has been the leading cause for premature birth, stillbirth, permanent disability, hemolytic anemia, and many other problems in women during pregnancy and even after pregnancy.
For over 60 years anti-Rh(D) immunoglobulin was approved for women with Rhesus Rh(-) negative antigen to prevent sensitization to the Rhesus positive Rh(+) blood group antigen before and after delivery,
Administering anti-Rh positive (D) immunoglobulin has been a great way to save the life of both the mother from developing antibodies and also save the life of the child.
Rhesus has been a great public health concern to those with low access to health care, most especially the low-income countries.
Some Developed countries practiced early detection of the fetus (baby) rhesus status in the mother’s blood at the early stage of pregnancy.
What is Rhesus Factor?
Rhesus factor is a genetic (inherited)condition that determines the mother and baby compatibility, however, Whenever there is an incompatibility in the blood status of both the mother and child, there will be room for complications.
All women are expected to know their status, especially during pregnancy to keep the fetus (baby) safe from damages to the blood cells and regret in future babies.
Rhesus status is not dangerous at the first pregnancy because there are already born by the time the immune system is ready to react to all future babies,
However certain situation can make one prone to complication, when a Rhesus negative Rh(-) mother has been sensitized of rhesus positive in the past,
it might be due to previous pregnancy and also by blood transfusion ( the body immune system quickly recognized the rhesus positive and it’s ready to fight the foreign body Rhesus positive ).
Types Of Rhesus Factor
They are two types of rhesus factor, The rhesus Rh(+) and rhesus Rh(-).
Rhesus positive signifies that there is a presence of protein in the blood in the red blood cell and rhesus negative indicates that protein is absent (not present in the red blood cell).
This signifies the presence of protein in the blood cell, when a woman has this protein Rh(D) she is not at risk of complication during pregnancy. Yet, it shows that she carrying the rhesus inherited.
Rhesus positive is usually common in people, about 85% of people are tested positive of Rhesus Rh(+), and it makes them safe from rhesus complications.
It is usually rare, studies have shown that 15% of people are down with rhesus negative, which indicates a lack of protein in the blood, A woman has to check her status again during pregnancy in the first trimester to confirm the status of the fetus(baby) she is carrying if the baby is negative and the mother is negative there won’t be any drawback.
What Causes Rhesus Disease?
The main cause of rhesus disease is Rhesus incompatibility, When there is a difference between the mother and child’s rhesus status it means the mother is carrying a Rhesus negative Rh(-)and the child is carrying a Rhesus positive Rh(D).
In this situation will say there is an incompatibility and this incompatibility leads to the body producing antibodies to fight off the foreign body which is the Rhesus positive Rh(+).
In the process of the body fighting this foreign body (Rhesus positive) there may be complications for both the mother and child. Early tests to determine your status reduces the risk of incompatibility.
It is advised for a woman to register for antenatal as soon as she is pregnant to be able to keep herself and her baby safe from any health challenges. Click Here To Read More On Hypertension:causes,symptoms,risk,prevention,treatment.
This usually occurs when the blood is incompatible especially through blood transfusion they include;
- Damaged red blood cell
- Miscarriage and Abortion
A Rhesus negative Rh(-) woman is 100% at risk of rhesus disease compared to men, due to pregnancy and exposure to a rhesus positive blood through blood transfusion. The Mother with a rhesus negative(-) which includes exposure to Rh-positive blood either by blood transfusion, through pregnancy.
Several doubts pop up and you want to answer how you can be diagnosed or how to determine the fetus (baby) rhesus status it’s simple.
Hematology (Blood) Test
Usually, it can be easily diagnosed with just knowing the father of the child’s rhesus status by conducting a blood test, but for certainty and to avoid misattributed paternity you may consider a DNA test.
DNA Test: this method is quite expensive and it’s not available in low-income countries in this situation the fetus DNA is gotten from the maternal bloodstream, collecting blood samples from the mother to determine the genotype of the fetus.
When there is an incompatibility in the rhesus factor there are several deformities they are;
- Hemolysis Anemia
- Heart Failure Of The Fetus
- Permanent Disability
- Brain Damage
Prevention And Management
- Health Education on rhesus disease, it’s the effect on mother and child.
- Sensitization of the mother’s immune system.
- Screening all mothers at their first prenatal visit for the rhesus antigen testing as well as their blood group.
- All women with Rhesus negative should be given anti-D immunoglobulin prophylaxis to prevent immunization and minimize hemolytic disease of the fetus and newborn.
- When young couples get married, you are expected to conduct several tests to know your status. Knowing your Rhesus (RH) status is also important to ensure the optimum wellbeing of the unborn child especially during and after pregnancy. Click here
The treatment of rhesus is to prevent sensitization of anti-D antibodies and it’s usually in two-stage.
1st Stage: Administer one single dose Of Anti-D immunoglobulin 1500 IU (300ug) to suppress 50mg of fetal whole bleeding blood usually lasts for 24hours this is usually given intravenously.it is given at 28weeks
2nd Stage: This particular is not given to all Rhesus negative mothers only those that have been confirmed that they are carrying a rhesus positive child and it is usually 72hours after giving birth.
Another situation may variant this stage of rhesus immunization which is;
- Ectopic pregnancy
- Maternal bleeding.
- Fetal death
- Antenatal vaginal bleeding
- Abdominal trauma
- Partial molar pregnancy
- Threaten abortion
- External cephalic version
- Invasive in utero procedure.
When there is an incompatibility, An Rh immune globulin treatment is given for about 28 weeks (7 months) of pregnancy and 3 days within the delivery early detection helps to eliminate the damages from incompatibility.
Most individuals are not aware of the Rhesus factor(RH) and they find it hard to believe that Rhesus factors can affect during pregnancy and at birth.
Women are at risk of rhesus incompatibility, Especially when she is Rh(-), All women are advised to go and check their status to determine their compatibility with the child when pregnant.
There is a reduced risk if it’s just the first pregnancy or else there is a mixture or leakage in the blood of the child and mother.
The essence of the anti-D immunoglobulin is to clear and avoid sensitization of the maternal immune system before it is activated.