What are risk associated with Rh incompatibity in conception? - Dr. Shefali Tyagi скачать в хорошем качестве

What are risk associated with Rh incompatibity in conception? - Dr. Shefali Tyagi

Rh incompatibility means that the woman can be Rh negative and the husband or the partner is Rh positive. So the problem arises only when there is a mismatch of Rh and the woman is negative. If the woman is positive and if the husband is negative, then we are not really bothered about pregnancy but once the woman is Rh negative, and the partner is Rh positive, there is a possibility that the baby can be either Rh negative or Rh positive. That we don’t know. So if the baby is Rh negative, actually there is no problem at all. But if the baby is Rh positive, what can happen is there is mixing of the other and the baby’s blood happens which happens generally in the 3rd trimester. The baby’s blood passes onto the mother’s system. Since the baby is Rh positive, it will have this foreign protein called as Rh, which the other does not have. So it is recognized as a foreign particle and the ,her will start forming antibodies against that Rh protein and these antibodies can pass onto the baby and start killing the baby’s cells leading to fall of hemoglobin in the baby leading to anemia and ultimately a condition called as hydrops can develop which can be life threatening for the bay and the baby can die inside the mother’s womb and that is a serious condition and how to tackle it is a blood test called as indirect comb’s test can be done when the woman has just conceived and then again at 28 weeks of pregnancy to see that antibodies are not there in the system. Once the ICT is negative, she can safely take one Anti-D injection which will safely block the antibodies and the baby will be safe. So one injection at 28 weeks, there are two types of regimes. some people give single dose at 28, some people repeated at 34 weeks and after delivery, the baby’s blood group is checked again. In case the baby is found to be positive, the anti-D is repeated once again. plus it is also important to take anti-D whenever you have any miscarriages in the first 3 months, ectopic pregnancy, any MTP done, which you have voluntarily terminate the pregnancy or any bleeding throughout the pregnancy you have to take anti-D if you are Rh negative, if you did not go for post miscarriage, the chances of antibodies developing will be still now because it is the first trimester of pregnancy. The problems arise in the 3rd trimester of pregnancy. But it is important to do the ICT test to know the status of antibodies in the body. If the ICT is negative, then it is all safe and the next pregnancy can be planned as usual. But if the ICT is positive, then it is high risk pregnancy and you need to be under the supervision of an obstetrician, who is used to dealing with high risk pregnancies. Because in this case, the baby has to be monitored for the development of fetal anemia from the 4th to the 5th month of pregnancy and repeated ultrasounds need to be done to see the MCA Doppler’s of the baby. In case they are rising, and it is indicating fetal anemia, you might need a blood transfusion if the baby is still in the womb, which is now done routinely and which is now a safe procedure.