After finding out about the pregnancy, it is necessary to schedule a visit to the doctor to start prenatal exams. Several tests and exams are carried out, including the Rh factor and the blood type of the father and mother to find out if there is any risk of incompatibility between the blood of the fetus and the mother.
There are some types of blood incompatibility. The most common is the ABO system, which happens when the father's blood is different from the mother's, regardless of the Rh factor. However, it is not necessary to worry so much about this problem, because the most that happens, in this case, is that the baby has a more yellowish color (jaundice) than normal. The treatment is done in the maternity ward itself, through a procedure known as phototherapy.
The major concern of all physicians is blood incompatibility with the Rh system, which is considered the most serious cases of fetal eristoblastosis or hemolytic disease. This happens when the child inherits the Rh positive factor from the father, but the mother has the Rh negative factor. And this can cause the death of the fetus during pregnancy or even after birth. In addition, hemolytic disease can cause profound anemia in the newborn, causing severe jaundice, brain paralysis and deafness.
It is worth noting that, when this type of incompatibility happens, the mother is also sensitized, and so her blood comes to see the baby as some sort of invader, and antibodies are created against it. During the first pregnancy, the antibodies created are large molecules, and therefore, cannot cross the placental barrier. That way, nothing happens if the mother's blood is brought into contact with the child's blood that is not compatible. However, if a second pregnancy occurs, and if the mother has not had a correct treatment before, the antibodies produced will be smaller, and thus, they will be able to reach the placenta, destroying the baby's red blood cells, which can cause an increase in amniotic fluid, generalized fetal edema and even death. Children who manage to survive end up with rare jaundice or severe anemia.
Therefore, to prevent this from happening, upon learning of pregnancy, the mother should start prenatal care. But despite all the care during this period, prevention must be done with the use of anti-D, a drug that fights sensitization during the 72 hours following delivery.
Prevention and Treatment
The best treatment to combat blood incompatibility is prevention. But, if the child is born with the problem, the first measure that must be adopted is the replacement of blood through transfusion with a negative Rh factor. The red blood cells that will be transferred survive for up to three months, after which they will be slowly replaced by the child's Rh positive type. When the process ends, there will be no more anti-Rh antibodies from the mother in the child's circulation.
Recommendations
Before becoming pregnant, all women should know whether their partner's Rh factor is positive or negative.
After the pregnancy is confirmed, a man with an Rh factor positive with an Rh positive woman, the Coombs test should be performed so that the presence of anti-Rh antibodies is detected in the blood.
Text written by Flávia Faria from the Eu Sem Fronteiras Team
