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When is the fetus at risk?
If you’re Rh-negative, getting RhIg injections after every possible contact with Rh-positive blood between you and the fetus reduces the risk of them getting Rh disease. Rh incompatibility doesn’t affect your health, only the fetus’s health. Rh factor (or Rhesus factor) is a type of protein on the outside or surface of your red blood cells. You inherit the protein, which means you get your Rh factor from your biological parents. If the father of your child is Rh-positive or his blood type is unknown, receiving preventive treatment with immune globulins will prevent serious effects. If you’re pregnant and your doctor determines that you’ve already developed antibodies against your baby, your pregnancy will be closely monitored. When your baby’s healthy red blood cells are destroyed, bilirubin will build up in their bloodstream.
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If the embryo’s blood crosses into Bella’s system, her body will become sensitized to that Rh-positive blood. When this happens, Bella’s body creates antibodies that will attack the blood of any subsequent pregnancies that are also Rh positive. The red blood cells in future pregnancies will be attacked, causing anemia, serious illness, brain damage, or even miscarriage. The initial pregnancy and each subsequent pregnancy must be treated.
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Even if that pregnancy ends in miscarriage, ectopic pregnancy, or abortion, the answer to this question matters for every pregnant person (especially those who may experience future pregnancies). Your doctor can test your baby’s blood for the presence of maternal antibodies that are breaking down the red blood cells. Your health care provider will advise that you have a blood type and Rh factor screening test during your first prenatal visit. This will show whether you are Rh positive or Rh negative.
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A similar hazard exists during pregnancy for the Rh-positive offspring of Rh-incompatible parents, when the mother is Rh-negative and the father is Rh-positive. The first child of such parents is usually in no danger unless the mother has acquired anti-Rh antibodies by virtue of incompatible blood transfusion. During labour, however, a small amount of the fetus’s blood may enter the mother’s bloodstream. The mother will then produce anti-Rh antibodies, which will attack any Rh-incompatible fetus in subsequent pregnancies. This process produces erythroblastosis fetalis, or hemolytic disease of the newborn, which can be fatal to the fetus or to the infant shortly after birth.
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With Rh incompatibility, your immune system reacts to this difference (known as incompatibility) and creates antibodies. These antibodies drive an immune system attack against the fetus’s red blood cells, which your body thinks are foreign objects. Your pregnancy care provider can prevent this from happening by giving you a shot (injection) of immune globulin. 3 Although the Rh blood group systems consist of many antigen subtypes (eg, D, C, c, E, e), the D antigen is the most immunogenic and therefore most commonly is involved in Rh incompatibility. This can result in fetal anemia, hyperbilirubinemia, erythroblastosis fetalis, or hydrops fetalis. Once sensitized, it takes up to 15 weeks for Rh antibodies in the maternal circulation to equilibrate in the fetal circulation, and in 90% of cases, sensitization occurs during delivery. Imagine that there is an Rh-negative woman who is pregnant for the first time, and her developing embryo is Rh positive.
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- However, a small amount of your baby’s blood could come in contact with your blood when the baby is born.
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- Red blood cells are needed to carry oxygen throughout the body.
- The first child of such parents is usually in no danger unless the mother has acquired anti-Rh antibodies by virtue of incompatible blood transfusion.
- Usually, your blood doesn’t mix with your baby’s blood during pregnancy.
- The blood sample usually is taken during the first prenatal visit and sent to a lab for testing.
The trait’s highest incidence is among the Basques of the Pyrenees (25–35 percent) and the Imazighen (Berbers) of Africa and the Bedouins of the Sinai Peninsula (18–30 percent). Copyright 2025 by the American College of Obstetricians and Gynecologists. Read copyright and permissions information.This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care.
What to know about the Rh factor
Create a new account or use an existing email address from any email provider; you’ll just need to provide a password, date of birth, and a mobile number. Starred messages appear in their own panel on the top right of your inbox. Every blood donation will undergo an Rh factor screening test, as well as tests for various infectious diseases, to ensure that it is safe for the recipient. Our Find a Provider tool makes it easy to search Cleveland Clinic’s trusted network.
Can Rh incompatibility be prevented?
Since Rh immune globulin won’t be helpful, the best treatment is close monitoring for the remainder of your pregnancy. There’s a small chance your provider will want to deliver early, but this depends on how severe the fetus’s Rh disease is. Complications don’t usually happen during a woman’s first pregnancy. This is because it’s unlikely that your blood will mix with the fetus’s blood until delivery, which means game chicken road antibodies won’t form until after the fetus is born.
What complications are associated with Rh incompatibility?
Providers can use special lights to help reduce bilirubin levels in fetuses that have jaundice. You may need to give birth early to avoid serious complications of anemia. If you’re Rh-negative and your antibody screen is negative, your provider will give you Rh immune globulin to prevent antibody formation. You’ll typically get this around 28 weeks of pregnancy and then again within 72 hours of delivery if the fetus is Rh-positive. You may get a dose in early pregnancy if your provider believes your blood has mixed with the fetus’s blood. Doppler ultrasonography of the middle cerebral artery peak systolic velocity (MCA-PSV) can noninvasively detect fetal anemia as early as 18 weeks’ gestation. 14, 15 When severe fetal anemia is suspected, cordocentesis provides confirmation. Even after successful IUT, affected infants often require exchange transfusion and/or phototherapy after birth.
