by Odia Iyoha
The Rhesus Angle:
As we learnt in our earlier series, Rhesus factor also known as Rhesus D is a protein that is found on the surface of red blood cells. A higher percentage of the population carry the Rhesus factor (Rh D) protein on their cells which makes them Rh D positive. Very few people don’t have the protein and are Rh D negative. A Rh D positive man and Rh D positive woman, Rh D negative man and Rh D negative woman, Rh D negative man and Rh D positive woman can get married without any medical concern but when a Rh D negative woman marries a Rh D positive man, concerns are raised. This is because it is very likely for the baby to be Rh D positive, if it gets it from the father.
Rhesus factor is genetic based. It is hereditary and can be passed from any of the parents to their offspring and in most cases, it is inherited from the father and not the mother. If a mother who is negative marries a father who is positive, their first child is usually lucky to escape complications associated with Rh incompatibility at birth. But subsequent births may not be lucky. Rh incompatibility is not harmful to the mother but the child. During pregnancy, the maternal and fetal blood do not mix due to the placenta barrier, so there is no blood contact at all. It is during labour and delivery (vaginal or through caesarian section) that the blood can mix and cause antibodies to develop in the Rh D negative mother against Rh D positive antigen. When the baby’s blood mixes with the mother’s blood, antibodies are activated in the mother against the Rh factor.
The first child will always escape the attack but subsequent fetuses cannot escape because the mother’s blood now has the antibodies against Rh D positive factor which will readily attack anything it perceives as foreign not minding the fact that the baby is hers. The mother’s antibodies will attack the subsequent baby’s Rh D positive blood cells if it is Rh D positive, leading to Erythroblastosis Fetalis, a hemolytic disease of the newborn caused by blood grouping incompatibility.
Hey, big hugs to science and medicine, there is a solution to Rh factor incompatibility between mother and child and the solution lies in a Vaccine like compound called RHOGAM, also known as Rh immunoglobulin. It is a prescription drug given intramuscularly to prevent the formation of antibodies by the mother against Rh D positive antigens of the fetus.
Rhogam stops the immune system from attacking Rh positive cells. It is usually given in an identified case of Rh incompatibility at the twenty-eighth week of pregnancy. Without this preventive treatment, Rh incompatibility will destroy the baby’s red blood cells leading to hemolytic anaemia during subsequent pregnancies after the first. Red blood cells contain haemoglobin, an iron-rich protein that supplies oxygen to the baby. Without enough red blood due to the antibodies attack, the newborn won’t get enough oxygen and this could lead to Anemia and jaundice or more serious conditions such as cerebral palsy, mental retardation, heart failure and death. It is possible for the baby to die during its pregnancy like in the story above if its red blood cells have been destroyed.
Other cases where Rhogam is given are:
- After a miscarriage (usually a first miscarriage because if not given after a first miscarriage and there is an issue of Rh incompatibility, giving it after a second miscarriage will be pointless because the mother’s immune system would have developed antibodies against Rh-positive blood already.)
- After an abortion. (also usually after a first abortion because if not given after a first abortion and there is an issue of Rh incompatibility, giving it after a second abortion will be pointless because the mother’s immune system would have developed antibodies against Rh-positive blood already and may affect subsequent pregnacies.)
- After pregnancy screening tests like chorionic villus sampling (CVS) and Amniocentesis.
- After genetic tests that require inserting a needle into the mother’s womb to sample the baby’s cells.
- Ectopic pregnancy.
- Uterine bleeding/bleeding during pregnancy.
- Any trauma during pregnancy that could leak some fetal cells to the mother.
- After delivery, within seventy-two hours if the baby’s blood is Rh-positive while the mother is Rh negative but if it is Rh negative, the injection is not necessary.
In our last story, Princess Wemimo’s miscarriages were as a result of the antibodies her immune system had developed at the point of birth of Princess Adetoun which were attacking subsequent Rh D positive fetuses and destroying them. If she didn’t go into early labour and had taken the Rhogam injection before the birth of her first child, she would have been able to have more biological children because the injection would have prevented her body from developing immunity against Rh D positive factor. It is very important to get all tests done before marriage to avoid telling sad tales when problems of incompatibility may arise due to your fault.
I hope you picked one or two lessons from this topic? These stories are to make you aware of blood groupings and their importance in Life. Please speak to your Physician for further advice and guidance on blood grouping if you have any issues on it. If you do not know your blood type and Rhesus grouping, I hope this charges you to visit a reputable Hospital or Laboratory to get the tests done as soon as you are able to do so.
Have a fun time!
Op–ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija
Tales from the grave is a medical series on the potential killer Rhesus Factor Incompatibility
