By Katie Powers, R.N
Bradenton Herald
bradenton.com

During my pregnancy I had to have a special medication because I was Rh negative. Why?

During pregnancy the mother’s blood and the baby’s blood co-mingle. When the mother’s blood is different than the baby’s blood, the mother’s blood becomes sensitive to the difference. The mother can develop antigens that can attack the baby’s blood cells


and destroy them. This is referred to as isoimmunized.

If the mother’s blood and the baby’s blood are the same Rh, then there is no problem.

The first time a woman is pregnant, and if the baby has a different Rh, the mother will develop just a few antigens. However, if she has successive pregnancies with a baby who has a different Rh factor, she will develop more and more of these attack antigen cells.

In 1968 the drug Rhogam was licensed for use in this country. Rhogam is known as D immunoglobulin. It can be remarkably successful in the prevention of isoimmunization to the D antigen, although complete protection cannot be achieved. It is the best we have at this time.

It is usually given to women around the 28th week of a pregnancy if the woman is Rh negative. Rh positive mothers do not need this medication.

After delivery, we always test the baby’s blood to determine blood type. If a baby is Rh positive and the mother is Rh negative, then we give another shot of Rhogam to the mom. This is to protect future babies that the mother may have.

Prior to 1939 the only significant blood group antigens recognized were A, B and O. Transfusion medication was thus based on the matching of ABO groups. In spite of ABO matching, blood transfusion continued to result in unexplained morbidity (sickness) and mortality (death).

As the 1930s ended, two significant discoveries were made that would further the safety of blood transfusion. These discoveries eventually would result in defining the most extensive blood group system known. That blood system is commonly called “Rh” after the rhesus monkey. Technically, however, it is known as D. A person with the D factor in their blood is Rh positive.

In 1930, two doctors named Levin and Stetson reported on a woman who had experienced a blood transfusion after a stillbirth delivery. She had received blood from her husband. By 1939 standards, their blood should have been compatible. However, after the transfusion the woman became sick and her baby died from Erythroblastosis Fetalis. The doctors did further testing on the parent’s blood and found that for some reason their blood reacted differently.

Around the same time two other scientists, Landsteiner and Wiener reported on an antibody made by guinea pigs and rabbits when injected with rhesus monkey red blood cells. They then conducted similar experiments with human blood. The blood seemed to have a factor that caused 85 percent of the human red blood cells to clump together. These scientists decided to call the factor D but it became known as Rh.

Because there is no way of knowing the blood type of a baby before delivery, the shot of Rhogam is given to Rh negative mothers, just in case the baby is Rh positive.

This goes along with the saying: An ounce of protection is worth a pound of cure!
(snip)

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