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Atypical Antibodies, Rh factor, and Anti-D injection
Many pregnant women suffer from the presence of antibodies to antigens present on the surface of red blood cells. The presence of these antibodies negatively affects both the mother and the fetus during pregnancy.
How are these antibodies formed in women?
Because they are exposed to factors that stimulate their immune system to secrete these antibodies, such as:
**Blood transfusion containing these antigens
**Pregnancy with a fetus that has these antigens on the surface of red blood cells and mixing of the fetus's red blood cells with the mother's blood during pregnancy due to bleeding or miscarriage
What is the effect of the presence of these antibodies on the mother?
Difficulty in obtaining blood units that match her when she needs a blood transfusion
What is the effect of these antibodies on the fetus?
They cross the placenta and cause the breakdown of the fetus's red blood cells, which causes fetal anemia and causes cardiac failure and fluid accumulation in the body chambers and ultimately leads to the death of the fetus inside the womb
What is the most common type of antigen found on red blood cells that leads to the formation of antibodies in the mother's body that affect the safety of the fetus and pregnancy?
Rhesus factor
How are these antibodies tested in the mother's blood?
** Testing the mother's blood type at the beginning of pregnancy and at the 28th week of pregnancy
** Testing antibodies in the mother's blood at the beginning of pregnancy and at the 28th week of pregnancy
What can we do to prevent the formation of these antibodies in the mother if she is negative for the Rh factor and her husband is positive for the Rh factor?
1- Giving the ANTI-D injection when anything happens during pregnancy that may lead to the formation of antibodies such as:
**Bleeding or miscarriage
**Trauma to the abdomen
**Surgeries due to miscarriages or ectopic pregnancy
**Given as a preventive measure at 28 weeks to all pregnant women
**Given within 72 hours after birth
3- Ensure that the blood transfused to the mother at any time is compatible with her blood type and negative for antigens that she does not have
How to deal with pregnancy if these antibodies are detected in the mother's blood?
Check the level of antibodies in the mother's blood periodically to ensure that they do not reach a level that causes a problem
What do we do if the antibodies reach a level that harms the fetus (i.e. they are able to cross the placenta and reach the fetus)?
The fetus is monitored by ultrasound periodically to ensure that he does not develop anemia by monitoring the blood flow to the brain
What do we do if antibodies cause fetal anemia?
It depends on the gestational age. If the pregnancy is 35 weeks or more, then we deliver the fetus and transfuse blood to it in theNICU. However, if the gestational age is early, then we have to transfuse blood to the fetus inside the womb periodically until the fetus reaches a stage where we can deliver it.
Who monitors the fetus for anemia and transfuses blood to the fetus inside the womb?
Maternal and fetal medicine specialist
