Rh incompatibility occurs when Rh-negative woman exposed to Rh-positive blood cells develops Rh antibodies.
Red blood cell antigen named Rh factor after monkeys where discovered.
Rh incompatibility can happen when a Rh-negative mother is exposed to Rh-positive fetal red blood cells due to events including abortion, trauma, or delivery.
Rh incompatibility can arise if a Rh-negative woman is given Rh-positive blood. Blood banks favour “O negative” or “type O, Rh negative” as universal donors for emergencies without time to match blood types.
Fetal blood entering maternal circulation causes sensitization and antibody production against foreign Rh antigen.
Maternal Rh IgG antibodies stay for life and can pass to the fetus to the destruction of Rh-positive fetal erythrocytes.
Epidemiology
85% of population Rh positive due to presence of Rh erythrocyte surface antigen.
Southwest US has 1.5x national average incidence of certain conditions due to immigration and limited medical care.
17% of Rh-negative pregnant women exposed to Rh-positive fetal blood develop antibodies.
About 15-20% of White patients have Rh-negative blood type. Rh-negative blood type less than 5% in Asian and American Indian.
Anatomy
Pathophysiology
Study shows less than 1 mL of Rh-positive fetal blood can sensitize Rh-negative individuals to Rh incompatibility.
Rh antibodies in maternal circulation equilibrate with fetal circulation within a month. Firstborn infants with Rh-positive blood type are usually not affected due to insufficient time for maternal IgG antibody response.
Subsequent pregnancies with a Rh-positive fetus increase sensitization risk. In Rh-incompatible women, second pregnancies can result in mildly anemic infants.
Rh incompatibility only affects pregnant or future mothers. Rh-positive antibodies have no negative effects on Rh-negative women.
Etiology
The causes of Rh incompatibility are:
Ectopic pregnancy
Placenta previa
Placental abruption
Abdominal/pelvic trauma
In utero fetal death
Lack of prenatal care
Genetics
Prognostic Factors
Maternal Rh antibodies from fetal Rh-positive cells cause fetal hemolysis.
Bilirubin produced from fetal hemoglobin breakdown is transferred to mother through placenta, conjugated, and excreted.
Some infants show mild symptoms such as mild anemia and hyperbilirubinemia due to Rh antibodies from placenta.
Neurologic syndrome from bilirubin deposit in nervous system tissues.
Clinical History
Collect details including history of prior blood transfusion, previous pregnancies, and medical history to understand clinical history of patient.
Physical Examination
Maternal Examination
Fetal Examination
Neonatal Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Symptoms during pregnancy are:
Severe fetal anemia
Hydrops fetalis
Reduced fetal movements or distress
Symptoms at birth are:
Neonatal jaundice, hydrops fetalis, severe anemia
Differential Diagnoses
ABO Incompatibility
Hereditary Spherocytosis
Alpha-Thalassemia Major
Physiologic Jaundice
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Prehospital care personnel prioritize stabilizing mother and infant before quickly transporting them to specialized high-risk obstetric and neonatal facilities.
Management of Rh-negative pregnant woman with suspected fetomaternal hemorrhage in ED depends on presentation and gestational age.
Administer human anti-D immune globulin and refer for further evaluation for Rh-negative mothers.
Administration of Rh IgG is not helpful if mother has high Rh antibodies.
Refer to high-risk obstetrics centre promptly if sensitized. Rh incompatible infant in ED needs aggressive approach for respiratory/hemodynamic stabilization.
Emphasize early prenatal care to all pregnant women in the ED to prevent Rh incompatibility through early Rh IgG administration.
For Rh incompatibility cases, intervention procedure including intrauterine blood transfusion, planned early delivery, and exchange transfusion are indicated.
use-of-phases-in-managing-rh-incompatibility
In the initial treatment phase, the goal is to prevent maternal sensitization to Rh-positive red blood cells.
Pharmacologic therapy is effective in the treatment phase as it includes the use of blood derived products.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.
Rh incompatibility occurs when Rh-negative woman exposed to Rh-positive blood cells develops Rh antibodies.
Red blood cell antigen named Rh factor after monkeys where discovered.
Rh incompatibility can happen when a Rh-negative mother is exposed to Rh-positive fetal red blood cells due to events including abortion, trauma, or delivery.
Rh incompatibility can arise if a Rh-negative woman is given Rh-positive blood. Blood banks favour “O negative” or “type O, Rh negative” as universal donors for emergencies without time to match blood types.
Fetal blood entering maternal circulation causes sensitization and antibody production against foreign Rh antigen.
Maternal Rh IgG antibodies stay for life and can pass to the fetus to the destruction of Rh-positive fetal erythrocytes.
85% of population Rh positive due to presence of Rh erythrocyte surface antigen.
Southwest US has 1.5x national average incidence of certain conditions due to immigration and limited medical care.
17% of Rh-negative pregnant women exposed to Rh-positive fetal blood develop antibodies.
About 15-20% of White patients have Rh-negative blood type. Rh-negative blood type less than 5% in Asian and American Indian.
Study shows less than 1 mL of Rh-positive fetal blood can sensitize Rh-negative individuals to Rh incompatibility.
Rh antibodies in maternal circulation equilibrate with fetal circulation within a month. Firstborn infants with Rh-positive blood type are usually not affected due to insufficient time for maternal IgG antibody response.
Subsequent pregnancies with a Rh-positive fetus increase sensitization risk. In Rh-incompatible women, second pregnancies can result in mildly anemic infants.
Rh incompatibility only affects pregnant or future mothers. Rh-positive antibodies have no negative effects on Rh-negative women.
The causes of Rh incompatibility are:
Ectopic pregnancy
Placenta previa
Placental abruption
Abdominal/pelvic trauma
In utero fetal death
Lack of prenatal care
Maternal Rh antibodies from fetal Rh-positive cells cause fetal hemolysis.
Bilirubin produced from fetal hemoglobin breakdown is transferred to mother through placenta, conjugated, and excreted.
Some infants show mild symptoms such as mild anemia and hyperbilirubinemia due to Rh antibodies from placenta.
Neurologic syndrome from bilirubin deposit in nervous system tissues.
Collect details including history of prior blood transfusion, previous pregnancies, and medical history to understand clinical history of patient.
Maternal Examination
Fetal Examination
Neonatal Examination
Symptoms during pregnancy are:
Severe fetal anemia
Hydrops fetalis
Reduced fetal movements or distress
Symptoms at birth are:
Neonatal jaundice, hydrops fetalis, severe anemia
ABO Incompatibility
Hereditary Spherocytosis
Alpha-Thalassemia Major
Physiologic Jaundice
Prehospital care personnel prioritize stabilizing mother and infant before quickly transporting them to specialized high-risk obstetric and neonatal facilities.
Management of Rh-negative pregnant woman with suspected fetomaternal hemorrhage in ED depends on presentation and gestational age.
Administer human anti-D immune globulin and refer for further evaluation for Rh-negative mothers.
Administration of Rh IgG is not helpful if mother has high Rh antibodies.
Refer to high-risk obstetrics centre promptly if sensitized. Rh incompatible infant in ED needs aggressive approach for respiratory/hemodynamic stabilization.
Emphasize early prenatal care to all pregnant women in the ED to prevent Rh incompatibility through early Rh IgG administration.
Emergency Medicine
Support maternal mental health to reduce stress and support fetal health.
Severe Rh incompatibility refers to maternal-fetal medicine specialist referral for high-risk pregnancy delivery.
Prevent maternal-fetal blood mixing during delivery for safer outcomes.
Neonatal treatments include exchange transfusions and respiratory support for complications.
Proper awareness about Rh incompatibility should be provided and its related causes with management strategies.
Appointments with a physician and preventing recurrence of disorder is an ongoing life-long effort.
Emergency Medicine
Human anti-D immune globulin:
It suppresses the immune response of non-sensitized Rh O negative mothers exposed to Rh O (D) positive blood.
Emergency Medicine
For Rh incompatibility cases, intervention procedure including intrauterine blood transfusion, planned early delivery, and exchange transfusion are indicated.
Emergency Medicine
In the initial treatment phase, the goal is to prevent maternal sensitization to Rh-positive red blood cells.
Pharmacologic therapy is effective in the treatment phase as it includes the use of blood derived products.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.
Rh incompatibility occurs when Rh-negative woman exposed to Rh-positive blood cells develops Rh antibodies.
Red blood cell antigen named Rh factor after monkeys where discovered.
Rh incompatibility can happen when a Rh-negative mother is exposed to Rh-positive fetal red blood cells due to events including abortion, trauma, or delivery.
Rh incompatibility can arise if a Rh-negative woman is given Rh-positive blood. Blood banks favour “O negative” or “type O, Rh negative” as universal donors for emergencies without time to match blood types.
Fetal blood entering maternal circulation causes sensitization and antibody production against foreign Rh antigen.
Maternal Rh IgG antibodies stay for life and can pass to the fetus to the destruction of Rh-positive fetal erythrocytes.
85% of population Rh positive due to presence of Rh erythrocyte surface antigen.
Southwest US has 1.5x national average incidence of certain conditions due to immigration and limited medical care.
17% of Rh-negative pregnant women exposed to Rh-positive fetal blood develop antibodies.
About 15-20% of White patients have Rh-negative blood type. Rh-negative blood type less than 5% in Asian and American Indian.
Study shows less than 1 mL of Rh-positive fetal blood can sensitize Rh-negative individuals to Rh incompatibility.
Rh antibodies in maternal circulation equilibrate with fetal circulation within a month. Firstborn infants with Rh-positive blood type are usually not affected due to insufficient time for maternal IgG antibody response.
Subsequent pregnancies with a Rh-positive fetus increase sensitization risk. In Rh-incompatible women, second pregnancies can result in mildly anemic infants.
Rh incompatibility only affects pregnant or future mothers. Rh-positive antibodies have no negative effects on Rh-negative women.
The causes of Rh incompatibility are:
Ectopic pregnancy
Placenta previa
Placental abruption
Abdominal/pelvic trauma
In utero fetal death
Lack of prenatal care
Maternal Rh antibodies from fetal Rh-positive cells cause fetal hemolysis.
Bilirubin produced from fetal hemoglobin breakdown is transferred to mother through placenta, conjugated, and excreted.
Some infants show mild symptoms such as mild anemia and hyperbilirubinemia due to Rh antibodies from placenta.
Neurologic syndrome from bilirubin deposit in nervous system tissues.
Collect details including history of prior blood transfusion, previous pregnancies, and medical history to understand clinical history of patient.
Maternal Examination
Fetal Examination
Neonatal Examination
Symptoms during pregnancy are:
Severe fetal anemia
Hydrops fetalis
Reduced fetal movements or distress
Symptoms at birth are:
Neonatal jaundice, hydrops fetalis, severe anemia
ABO Incompatibility
Hereditary Spherocytosis
Alpha-Thalassemia Major
Physiologic Jaundice
Prehospital care personnel prioritize stabilizing mother and infant before quickly transporting them to specialized high-risk obstetric and neonatal facilities.
Management of Rh-negative pregnant woman with suspected fetomaternal hemorrhage in ED depends on presentation and gestational age.
Administer human anti-D immune globulin and refer for further evaluation for Rh-negative mothers.
Administration of Rh IgG is not helpful if mother has high Rh antibodies.
Refer to high-risk obstetrics centre promptly if sensitized. Rh incompatible infant in ED needs aggressive approach for respiratory/hemodynamic stabilization.
Emphasize early prenatal care to all pregnant women in the ED to prevent Rh incompatibility through early Rh IgG administration.
Emergency Medicine
Support maternal mental health to reduce stress and support fetal health.
Severe Rh incompatibility refers to maternal-fetal medicine specialist referral for high-risk pregnancy delivery.
Prevent maternal-fetal blood mixing during delivery for safer outcomes.
Neonatal treatments include exchange transfusions and respiratory support for complications.
Proper awareness about Rh incompatibility should be provided and its related causes with management strategies.
Appointments with a physician and preventing recurrence of disorder is an ongoing life-long effort.
Emergency Medicine
Human anti-D immune globulin:
It suppresses the immune response of non-sensitized Rh O negative mothers exposed to Rh O (D) positive blood.
Emergency Medicine
For Rh incompatibility cases, intervention procedure including intrauterine blood transfusion, planned early delivery, and exchange transfusion are indicated.
Emergency Medicine
In the initial treatment phase, the goal is to prevent maternal sensitization to Rh-positive red blood cells.
Pharmacologic therapy is effective in the treatment phase as it includes the use of blood derived products.
In supportive care and management phase, patients should receive required attention such as lifestyle modification and intervention therapies.
The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.
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