What is a blood type mismatch?

What is a blood type mismatch?

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RH Mismatch (Rh Hemolytic Disease)

Neonatal jaundice most commonly occurs due to blood group mismatch between mother and fetus. Rh incompatible hemolytic disease is the most important of these.

Each person is inherited either Rh positive (Rh factor dominant) or negative (Rh factor is absent). All pregnant women undergo the determination of gangrene and Rh factor in early pregnancy. There is no problem if the mother is Rh (+) (85%) or both her husband and herself are Rh (-). But the mother is Rh (-) and her husband is Rh (+). Pregnancy should be carefully monitored under medical supervision.
In the presence of the following conditions Rh-related disease develops;

  • Rh (-) mother and Rh (+) fetus
  • Transition of maternal red blood cells into maternal circulation
  • Maternal sensitivity to D antigen on fetal red blood cells and production of anti-D antibodies
  • The transfer of these antibodies to the fetal circulation through the placenta

There is almost no danger for the baby during the first pregnancy. The problem starts during the birth (during abortion or abortion) of the baby who has inherited Rh from her father. This happens when Rh (+) blood enters the circulation of the Rh (-) mother. The mother's immune system produces antibodies against this “foreign” substance. These antibodies are harmless until they become pregnant with another Rh (+) baby. In such a case, the antibodies pass through the placenta and attack the baby's red blood cells (red blood cells), causing mild anemia if the mother's antibody level is low, and severe anemia if the mother's antibody level is high. In the first pregnancy, these antibodies occur in very rare cases, for which the baby's blood from the placenta must enter back into the mother's bloodstream.

Rh incompatibility is easier in cases of caesarean section and manual removal of placenta because placental bleeding is more frequent and more frequent.

If Rh incompatibility occurs in the first pregnancy, it is almost always related to previous miscarriage, ruptured ectopic pregnancy or pre-sensitization due to incorrect blood transfusion.

Today, the way to protect the baby in Rh incompatibility is to prevent the formation of Rh antibodies. At 28 weeks, a dose of Rh immunoglobulin is given to the Rh (-) mother who has no antibody in her blood. If the baby is Rh (+), the second dose is given 72 hours after birth. This dose is also given if the vaccine is aborted, abortion, amniocentesis or bleeding during pregnancy.

Amniocentesis can be performed to determine the baby's blood type if the tests show that Rh antibodies have already developed in the pregnant woman. If the levels rise dangerously, tests are performed to assess the baby's condition. If the baby's condition is in danger, Rh (-) blood transfusions may be required. If the Rh mismatch is serious, which is rare, blood is transfused while the baby is in the uterus. Mostly, it can be expected until immediately after birth. In mild cases, antibody levels are low and blood transfusions are not required. But the physician should be prepared for the possibility that it is necessary after birth.

The use of Rh immunoglobulin has reduced the need for blood transfusions to less than 1% in pregnancies with Rh incompatibility.


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