What are the complications of rhesus negative (RhD negative) if I don’t go for treatment?

Without injections of anti-D, the immune response can cause rhesus disease for your baby since it gets stronger after the first pregnancy. The antibodies keep attacking the blood cells in your baby’s body during pregnancy and months after she is born.

When blood cells are destroyed, your baby will develop anemia. In severe cases, anemia leads to fatal problems including swelling, heart failure, and fluid retention.

After birth, your baby’s liver is no longer able to deal with the volume of blood cells broken down. Thus, she may have jaundice, also known as HDFN (hemolytic disease of the fetus and newborn) or HDN hemolytic disease of the newborn.

Severe HDFN leaves your baby with permanent brain damages and neurological problems including cerebral palsy, physical problems or speech problems.

Since rhesus disease is dangerous, you need to have a blood test as required to see if you are rhesus negative. If you are really rhesus negative, take the routine anti-D injections to avoid unwanted consequences.

What should I do if I already have antibodies in my blood?

During the early days of your pregnancy, your health care provider will do the blood test to check for your antibodies. This test is done once again at week 28. Sometimes, you get those antibodies from a previous termination, ectopic pregnancy or miscarriage but you are not aware of it.

If the antibodies are already present in your blood, anti-D injections no longer work for you. They can only prevent the antibodies from being produced (sensitization). They are not able to remove the antibodies that already exist. What you should do is seeking help from a specialist.

Your specialist will keep monitoring your pregnancy to watch out for anemia that may develop in your baby. Blood transfusions to the baby (since she’s still in the uterus) can be helpful in treating severe anemia. Nonetheless, for a higher chance of more effective treatment, it’s better to induce delivery or use a C-section.

After birth, your baby may be taken care of in a neonatal unit. Phototherapy along with blood transfusion can help to deal with jaundice and anemia.

Luckily, minimal treatments work for most cases of mild rhesus disease. However, for severe cases, an injection of a solution of antibodies is required to help save the baby’s blood cells from being destroyed.

What happens after my baby is born?

After the baby is born, the doctor will take a sample of blood from her umbilical cord to test the blood group and rhesus status.

If your baby is determined rhesus positive, you will receive one more anti-D injection within 72 hours of childbirth. This is to make sure that your immune response is not triggered. Your doctor also takes a blood sample of yours from the vein right after the delivery to test for antibodies. The more fetal blood found in your body, the higher dose of anti-D you will need. In the scenario where both you and the baby are rhesus negative, there is no need for anti-D.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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Assoc. Prof. Dr. Thuaibah Bt Hashim Pathology - Histopathology & Cytology

    Assoc. Prof. Dr. Thuaibah Bt Hashim is currently a lecturer in Pathology at Cyberjaya University College of Medical Sciences, Malaysia, under the Department of Basic Medical Sciences, Faculty of Medicine.

    Dr. Thuaibah is a pathologist expert, subspecialized in Renal Histopathology. Besides teaching, her extracurricular activities involve various charity events under Pertubuhan Ikram Putrajaya and Surau AlMunawwarah Bangi Golf Resorts.She is also a member of Persatuan Perubatan Islam Malaysia; College of Pathologists, Academy of Medicine Malaysia; and the Persatuan Alumni Sekolah Seri Puteri.

    Dr. Thuaibah has various publications about Pathology and prestigious awards, including:

    1. Certificate of appreciation and incentive for contributing to eradicate an outbreak of Nipah encephalitis in Negeri Sembilan from Ministry of Health Malaysia, 1999.

    2. Prize & Certificate of Excellent Service in conjunction with the Quality Day, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia 2002.

    3. Outstanding Service Award 2003 from Universiti Putra Malaysia.

    4. Anugerah Jasa Putra 2006 from Universiti Putra Malaysia.

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