Rh factor is a protein that may be present on your red blood cells in addition t

Question

Rh factor is a protein that may be present on your red blood cells in addition to the A and B antigens. Rh acts as an antigen just like A and B. When an Rh- woman is pregnant with an Rh+ baby, doctors must monitor the mother carefully to check whether she is producing antibodies to the Rh antigen. Explain why the mother could make antibodies to Rh and how these could be damaging to the baby. If an Rh- woman has a second child who is also Rh+, doctors are even more vigilant about monitoring Rh antibody levels. Using your knowledge of antibody response to a second exposure, explain why there is more concern for the second Rh+ baby When an Rh woman is pregnant with an Rh- baby, there is no special monitoring that must be done. Why not?

Explanation / Answer

Rh factor is a protein that is present on RBC, with Rh+ being the dominant trait and Rh- being the recessive trait.

a. Rh factors get inherited from parents, where is a mother is Rh- and father is positive, Rh+ blood is inherited into the baby because Rh+ trait which is dominant allele here. However, This poses a threat to the fetus during pregnancy as the Mother's blood contains Rh- factor and fetus is Rh+. The mother's body starts synthesizing antibodies against the fetus considering it as a foreign body. This process occurs only when mother's and baby's blood are mixed, which generally doesn't occur during pregnancy unless the mother has had any one of the procedures or complications:

Amniocentesis, Chorionic villus sampling, bleeding during pregnancy, breach rotation of the baby for labor, or an abdominal trauma during pregnancy. However, serious problems do not occur during first pregnancy with the Rh-positive baby if preventive measures are followed.

b. If the Rh- mother has another baby with Rh-positive blood type, there could be serious implications of Rh incompatibility which would lead to hemolytic anemia and death of fetus because the mother's body which is already sensitized o the Rh+ blood through fist pregnancy, actively synthesizes antibodies against the fetus and attacks the Rh+ fetus blood. A shot of Rh immunoglobulin would prevent further complications for second pregnancy as this targets Rh positive cells in the blood and prevents the body from synthesizing antibodies against it.

c. When Rh+ women is carrying and Rh- baby, this complication doesn't occur as because Rh- fetus ha no antigens on the surface of RBC to trigger antibody production the either Rh+ or Rh- mother, and a fetus system is not so developed to create antibodies against the mother blood in case of Rh+ mothers carrying Rh- baby.

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