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DisulfideBondage t1_j1pkugs wrote

Risk is low during normal pregnancy. The risk is elevated during labor. If the mother’s blood gets into the child’s bloodstream it can cause pathological jaundice as the child’s immune system attacks the foreign blood cells breaking down the hemoglobin, elevating bilirubin levels.

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whyyou- t1_j1q06cz wrote

Depends; ABO incompatibility is not really an issue, Rh incompatibility is more serious but only if the mother negative and has been previously exposed to Rh(+) antigen (a previous pregnancy, blood transfusions). If the mother has been exposed and mother / baby are incompatible (mother negative, baby positive) it can lead to hemolytic disease of the fetus an autoimmune disease that breaks down the fetus blood cells and can be so severe to cause intrauterine death.

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ModlrMike t1_j1qaupw wrote

All Rh- pregnant women are given RHIg (WinRho, Rhogam etc) to minimize the chance that there is Rh incompatibility. While it is possible to assume that there will be no issues when both parents are Rh-, it is generally accepted practice to immunize the mother just the same. This page from Cleveland Clinic has a good explanation of the issue:

https://my.clevelandclinic.org/health/diseases/21053-rh-factor

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dangelem t1_j1qn79p wrote

Well blood types A, B, and AB produce mainly IgM antibodies which cannot cross the placenta so this is really only an issue when the mother is blood type O, which produces mostly IgG antibodies that can in fact cross the placenta. However I think the percentage of developing HDN is very low, something like 4%, and when it happens it is mild. Something about the baby’s antigens not being properly developed so the antibodies cannot properly bind to destroy the blood cells.

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AmbilevousMD t1_j1qnjg8 wrote

Replying to DisulfideBondage (#1,070,149)

This is kind of the opposite of what usually happens. During pregnancy, fetal red cells can cross the placenta causing an immune reaction in Mom. The antibodies from this reaction cross the placenta and can attack fetal red cells. There is a spectrum of severity ranging from hydrops fetalis to clinically insignificant. The antibodies linger in fetal circulation after birth and subsequent red cell destruction can contribute to jaundice. You can test for the presence of these antibodies with a Coombs test.

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Voctus t1_j1qpyn0 wrote

Replying to ModlrMike (#1,073,525)

Where I live they find out the fetus’s blood type and check for mismatch. There is enough fetal dna floating around in the mother’s blood to check things like blood type, gender, and chromosomal abnormalities (like Down’s syndrome).

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No-Owl-295 t1_j1rg688 wrote

Replying to kkngs (#1,073,047)

Which only works if her body did not form antibodies yet. If she already has antibodies and the fetus survives the first few weeks, they usually need several intra-uterine blood-transfusions.

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CartographerMore9712 t1_j1roe1t wrote

Replying to ModlrMike (#1,073,525)

I work in a blood bank. From when the mother is greater than 12weeks gestation we can test the free fetal Dna is her blood to predict the baby’s Rh status. Only the women with predicted Rh positive babies will then receive the RhIg injection. With us the mothers will receive the RhIg injection routinely at 28weeks gestation but they will also receive it for any potential sensitising event throughout the pregnancy such as abdominal trauma or pv bleeds.

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CartographerMore9712 t1_j1rpoqq wrote

Replying to DisulfideBondage (#1,070,149)

It’s the opposite. Yes The risk is low during pregnancy and is more likely to occur during delivery but it’s the baby’s blood that passes into the mothers blood stream causing the mother immune system to produce antibodies against the baby’s blood. These antibodies can pass across the placenta and attack the baby’s blood cells causing them to be destroyed. It is then the subsequent pregnancies that the Fetus and baby are affected.

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Jimboats t1_j1rsy16 wrote

Replying to CartographerMore9712 (#1,080,171)

I think this must be country-dependent. In the UK all Rh- women are given the injection. I mean, how can you be certain that the father is really the father of that child? Surely that must give rise to a non-zero number of cases where there is a high risk of a baby being exposed unnecessarily?

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ohdearitsrichardiii t1_j1rw3wu wrote

Replying to Jimboats (#1,080,805)

They don't care about the (potential) father's blood type, they can tell the fetus's blood type from the mother's blood sample. I'm Rh-, they could see when I was about 10 weeks pregnant that my kids were Rh+ so I got the serum

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CartographerMore9712 t1_j1s0vuo wrote

Replying to Jimboats (#1,080,805)

They do free fetal DNA testing in the Uk. The IGBRL in Bristol is one of the major testing centres there. They can predict the Rh status of the baby from the baby’s DNA circulating in the mothers blood. About 35-40% of Rh- mothers will have Rh- babies. I will say not all maternity hospitals avail of this test but it is available

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Dramatic-Move8793 t1_j1stzyf wrote

If the mother has Rh negative blood and becomes pregnant with a baby who has Rh positive blood, the mother's body will see those Rh antigens as foreign particles and will try to fight it off. Typically the first pregnancy is okay. But the mother's body will have built up an immunity against the Rh antigen by the second pregnancy.

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SBG_Mujtaba t1_j1sypdh wrote

Depends, during first pregnancy, there might be no complications, other than may be IUGR, during second if the mother hasn’t been given immuno suppressant then she will develop anti bodies that causes issues in following pregnancies.

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onewilybobkat t1_j1t1gjp wrote

Replying to dangelem (#1,075,158)

Just to add, look up James Anderson. He has an antigen that saved a ton of babies from being attacked by their mothers blood because it was incompatible. Complications can arise to do conflicting blood types.

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runthereszombies t1_j1xok8e wrote

The most important consideration is the D antigen aka Rh antigen which doesn't affect the first pregnancy, as others have said. If mom is Rh- and dad is Rh+, there is a chance that the fetus is Rh+. During pregnancy and especially during childbirth or miscarriage, the mother and fetus exchange blood. Mom's body recognizes the fetus' Rh+ blood as foreign and generates antibodies against this factor. This won't affect the initial pregnancy. However, if mom gets pregnant again with an Rh+ baby, then the antibodies will cross the placenta and attack the baby's red blood cells, causing a disease called hemolytic disease of the newborn. Its a serious form of anemia that can kill the baby.

This is why Rh- moms are given Rhogam, an antibody against this antigen. The idea is that during that first pregnancy, the Rhogam will "hide" the Rh antigen from the mother's immune system, preventing the formation of those antibodies and protecting future pregnancies.

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