How frequent is rhesus immunization?
Seen around 100 cases of rhesus immunisering a year in Denmark, of which 10 are serious and require blood transfusions.
What causes rhesus immunization?
A rhesus negative woman should be exposed (exposed) of rhesus positive blood before or during the current pregnancy, in order that she may develop rhesus antibodies against rhesus Antigen on fetal red blood cells. Such exposure can occur by random bleeding in pregnancy, but it happens in most cases during a birth. The mother may then developing rhesus antibodies, which in later pregnancies is crossing the placenta and attack the fetal red blood cells.
By weak attacks on fetal red blood cells, the embryo can counteract the attack by forming more red blood cells. In case of severe attacks get fetus blood deficiency, and as a result of the lack of blood can the fetus gain large fluid build-up in the whole body, heart failure, and in the worst case will die inside the uterus.
As long as the fetus is in inside the uterus, will waste substances from the destroyed red blood cells are transferred to the mother’s orbit, and the mother will then break down and eliminate waste substances. After giving birth to the fetus even break down the waste, and they can then deposited, inter alia. in fetal skin and give jaundice. By very severe destruction of fetal red blood cells will accumulate bile pigments with the newborn, which can lead to brain damage in the newborn child.
What are the symptoms of rhesus immunization?
In most cases the mother has no symptoms ease. In the most severe cases will the mother could experience reduced fetal movements.
What symptoms you should pay particular attention to?
Reduced fetal movements.
How the diagnosis is made?
All pregnant women are offered to have taken blood test for blood and blood test for antibodies at the first medical examination.
All rhesus D negative pregnant get further taken a blood test for the determination of blood group antibodies in week 25 of the practitioner. At the same time investigated fetal rhesus type on the second blood sample, thus giving birth to the site has the answer and can act on it, when the woman comes to a midwife in week 29. Fetal blood type can be tested on a standard blood sample from the mother. In pregnant women’s blood, there are small amounts of free material from their fetuses. An analysis of the free material can show whether the fetus is rhesus positive.
In rare cases, made the diagnosis by that well ultrasound detected blood deficiency in the fetus.
Suspected severe impact of the baby’s red blood cells will be under ultrasound guidance, take a blood sample from the fetal umbilical cord in order to determine the child’s blood percentage. If the fetus has very low blood percent can have one or more blood transfusions the fetus through the umbilical cord.
What treatment is there?
All pregnant women who are rhesus negative in Denmark, treatment with a drug (anti-D), which prevents the formation of RH antibodies. Anti-d is given as a single injection with 250-300 micrograms by 29. pregnancy weeks if the fetus is rhesus positive.
Anti-d is also given as hitherto within 72 hours after a birth, where a rhesus negative woman has given birth to a rhesus positive baby. All rhesus negative pregnant after 8. weeks pregnant or more have undergone spontaneous or induced abortion, ectopic pregnancy or trauma against the stomach must had anti-D.
In pregnancies where the mother has found rhesus antibodies with, one will follow the fetus with ultrasound examinations. If the fetus has very low blood percent can get a blood transfusion the fetus through the umbilical cord.
By serious rhesus immunization redeemed the mother
How is long-term prospects?
The risk of the emergence of disease in fetuses in a possible new pregnancy, shall be assessed from the information on how it went in the previous pregnancy. By foetal death or development of very severe water retention of the fetus early in pregnancy, the chances of giving birth to living children in later pregnancies small.
How do I avoid getting or exacerbating rhesus immunization?
A rhesus negative woman cannot avoid being rhesus immunized, but it is important to have studied rhesus antibodies in connection with pregnancy and receive Anti-D injection, when there is a risk of immunization.