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Complications

for unborn babies: If resus disease causes severe anaemia in an unborn baby, it can lead to, foetal heart failure, fluid retention/swelling and stillbirth.

Newborn babies Rhesus disease causes a build up of excessive amounts of a substance called bilirubin. Without treatment this will build up = neurological condition. Hearing loss, blindness, vision loss, brain damage, learning difficulties, even death. Treatment for rhesus disease is effective.

Blood transfusions Developing an infection from blood transfusions is low. Blood is matched to the baby's blood type, adverse reactions are low. May be a problem with transfusion - the catherter used to deliver the blood can become dislodged, causing haemorrhage or blood clot. The risks associated with blood transfusions are small and dont outweigh the benefits of treating a baby with anemia.

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Rhesus disease is caused by a mix of blood types between a pregnant mother and the unborn baby, the disease occurs when the mother is rhesus negative, the baby has a rhesus positive blood type, or the mother o has been exposed to rhesus positive blood previously. A persons blood type depends on the genes inherited from your parents, a person can inherit one copy of the Rhd antigen from either mother or father, a copy from both or neither.

Sensation- during pregnancy sensation can occur when a small amount of foetal blood cells cross into the mothers blood, the mother is exposed to her baby's blood during delivery. Sensation can also occur after a miscarriage. If sensation occurs, the next time the woman is exposed to Rhd positive blood the body will produce antibodies straight away. If the baby is rhd positive the antibodies produced can lead to rhesus disease, as they will start to attack to the babys red blood cells.

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If your baby is found to be anaemic, they can be given a transfusion of blood through the same needle. This is known as an intrauterine transfusion (IUT) and it may require an overnight stay in hospital.

FBS and IUT are only carried out in specialist units, so you may need to be referred to a different hospital to the one where you are planning to have your baby.

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In unborn babies if developed while still in the womb- babies can become anaemic while in the womb due to red blood cells being destroyed faster because of the antibodies. blood will be thinner and faster - can be detected by ultrasound- in severe cases -internal swelling can occur which can be detected on scans.

Newborn baby - the 2 main problems caused by Rhesus Disease are Haemolytic anaemia and Newborn jaundice

Hypotonia( low muscle tone) and lack of energy can also be a symptom of rhesus disease.

Haemolytic anaemia is where mothers' negative blood crosses the placenta and attacks babies' positive blood which destroys red blood cells.

Jaundice turns baby skin yellow - this is a build of bilirubin in the blood- the liver cannot process high levels of bilirubin.

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Treatment for rhesus disease depends on how severe the condition is. In more severe cases, treatment may need to begin before the baby is born.

A treatment called phototherapy is usually needed and blood transfusions may help to speed up the removal of bilirubin (a substance created when red blood cells break down) from the body.

Using phototherapy can sometimes reduce the need for a blood transfusion.

Phototherapy is treatment with light. It involves placing the newborn baby under a halogen or fluorescent lamp with their eyes covered.

Alternatively, they may be placed on a blanket containing optical fibres through which light travels and shines onto the baby's back.

The light absorbed by the skin during phototherapy lowers the bilirubin levels in the baby's blood through a process called photo-oxidation. This means that oxygen is added to the bilirubin, which helps it to dissolve in water. This makes it easier for the baby's liver to break down the bilirubin and remove it from the blood.

If your baby develops rhesus disease while still in the womb, they may need to be given a blood transfusion before birth. This is known as intrauterine foetal blood transfusion.

A needle is usually inserted through the mother's abdomen (tummy) and into the umbilical cord, so donated blood can be injected into the baby.

Intravenous immunoglobulin helps to prevent red blood cells being destroyed, so the level of bilirubin in your baby's blood will stop rising.

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Rhesus disease, also known as hemolytic disease of the fetus and newborn (HDFN), occurs when an RhD-negative mother becomes sensitized to RhD-positive blood cells, leading her immune system to produce antibodies that can attack the red blood cells of an RhD-positive baby in current or future pregnancies.

–sensitization can happen:

uring pregnancy,

childbirth,

miscarriage,

or certain medical procedures.

Administered to all RhD-negative pregnant women who haven't been sensitized. RAADP can be given as either a single injection between the 28th and 30th weeks of pregnancy or as two injections at the 28th and 34th weeks. Both methods are effective in preventing sensitization

After childbirth, if the newborn is RhD-positive and the mother hasn't been sensitized, an injection of anti-D immunoglobulin is offered within 72 hours of delivery. This neutralizes any RhD-positive cells that may have entered the mother's bloodstream during birth, reducing the risk of sensitization in future pregnancies.

Anti-D immunoglobulin is also recommended if there's a risk that fetal RhD-positive blood cells have entered the mother's bloodstream during events such as:

Vaginal bleeding during pregnancy

Invasive procedures like amniocentesis or chorionic villus sampling

Abdominal injury

Miscarriage or termination of pregnancy

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Blood sample from baby’s blood is taken from the umbilical cord, if mother and baby are not Rhesus compatible (negative and positive) – the mother will be offered anti-D immunoglobulin injection within 72 hours after giving birth to destroy blood cells that may have mixed. This decreases the risk of any further pregnancies being affected by rhesus disease.
It is possible the mother may have a small allergic reaction from the anti-D which can result in flu-like symptoms or may develop an infection from the injection. However benefits of preventing sensitisation outweigh the reaction risks.