What is Pregnancy Follow-up in Those with Blood Incompatibility? How To?

Blood incompatibility is caused by incompatibility of blood groups between the mother and the baby. The most common one is Rh (rhesus) incompatibility. In case of blood incompatibility, pregnancy monitoring takes place in many steps. Since it is a condition that may pose a risk to the mother and baby, blood incompatibility is closely monitored. In this article, we talked about what pregnancy follow-up is and how it is done in those with blood incompatibility.

What is Pregnancy Follow-up in Those with Blood Incompatibility?

The blood incompatibility situation can be explained with a small example. For example; If an Rh- expectant mother has an Rh+ baby in her womb, sensitization may occur. In this case, the baby may carry Rh antigen in his red blood cells and the expectant mother may produce antibodies against this foreign antigen. These antibodies can attack the baby’s red blood cells and destroy the blood cells. This may result in serious anemia, brain damage or infant death. This is why blood incompatibility monitoring is of great importance. Expectant mothers affected by blood incompatibility are also considered to be at risk.

How to Follow Pregnancy in People with Blood Incompatibility?

We can list the steps of pregnancy follow-up in expectant mothers with blood incompatibility as follows:

• Diagnosis: In case of blood incompatibility, the blood type and Rh factor of the expectant mother and father are usually examined. If the mother is Rh negative and the father is Rh positive, the baby may be Rh positive and the mother’s body may produce Rh antibodies that are incompatible with the baby. These pregnant women are called pregnant women with blood incompatibility. It is decided whether the expectant mother is sensitized or not by performing a test called the Indirect Coombs test. If the indirect Coombs test is positive at 1/32 and above, this is called sensitized Rh Rh incompatibility of the expectant mother. This group is the most important and risky group.

• First Follow-up: In the early stages of pregnancy, antibody levels in the mother’s blood are checked with the Indirect Coombs (IDC) test.

• Rh Immunoglobulin (Anti-D) Drug Administration: Rh negative mother can receive anti-D immunoglobulin injection at certain times of pregnancy. This injection is given to prevent the production of antibodies in the mother’s body when the baby comes into contact with Rh-positive blood cells. The injection is usually given in case of bleeding, during the 28th week of pregnancy and after birth. However, what is important is that this drug is administered to patients with a negative IDC test.

• Ultrasound: Regular ultrasound scans are performed in pregnancies with blood incompatibility. This examination is performed by perinatology specialists and its purpose is to evaluate whether the patient is affected by anemia.

• Intrauterine blood transfusion: If it is determined that the baby has serious anemia as a result of the examination performed during the follow-up of affected pregnant women, it is possible to treat the baby by giving specially prepared blood in the womb.

• Newborn Follow-up: Babies affected by blood incompatibility or who received a blood transfusion in the womb are at high risk even after birth. These babies may need blood transfusion after birth, and jaundice levels are expected to be high.

Follow-up of pregnancies affected by blood incompatibility should be done by perinatology specialists.

What Risks Does Blood Incompatibility During Pregnancy Carry?

Some risks may arise in case of blood incompatibility during pregnancy. These risks can affect the health of the mother and baby. Therefore, they are high-risk pregnancies and should be followed by a perinatologist. We can list the potential risks due to blood incompatibility during pregnancy as follows:

• Hemolytic Disease: Blood incompatibility between mother and baby can cause the mother’s body to produce antibodies against the baby’s Rh-positive blood cells. These antibodies can target the baby’s red blood cells, causing their destruction. This condition is known as hemolytic disease and can lead to serious complications such as anemia, jaundice, and edema in the baby, also known as anemia.

• Hydrops Fetalis: Due to blood incompatibility, excessive destruction of red blood cells and anemia in the baby can lead to imbalance of body fluids and edema formation. This condition is called hydrops fetalis and is considered a serious complication. Hydrops fetalis can affect the baby’s heart, lungs and other organs, leading to life-threatening conditions.

• Premature Birth: Especially babies who received blood transfusion in the womb are delivered prematurely. For this reason, they are followed in intensive care. They may even need transfusion after birth, and they may need to receive phototherapy.

• Anemia and Hypoxic Damage: Due to hemolytic disease, anemia may develop in the baby. Anemia can cause insufficient oxygen transport and hypoxic damage to the organs in the baby’s body, that is, damage due to lack of oxygen.