Pregnancy with a negative Rh blood type

Medically reviewed: 21, October 2023

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Pregnancy and the negative Rh factor

Rh incompatibility occurs when there is a blood incompatibility between the mother and the fetus. It does not occur in every pregnancy. This problem used to be much more prevalent than it is now because now all pregnant women are tested for the Rh factor early in their pregnancy.

Blood typing, Rh determination, and antibody screening are done routinely at the first prenatal visit.

In brief, this is how Rh problems occur in a pregnancy. Everyone is born with a certain blood type that is either Rh positive (contains the Rh factor) or Rh negative (the Rh factor is missing). If you are Rh positive, or if your partner and you are both Rh negative, the condition does not occur.

Rh negative pregnancy complications

However, if you are Rh negative and your partner is Rh positive, this condition can occur. Also, if this is your first pregnancy (note that this is not the same as your first baby), there is little danger to your baby since the antibodies have not developed. If the baby is Rh positive, your body views your baby as a “foreign” intruder because the Rh factor is different from yours.

Your body produces antibodies to destroy the “foreign” red blood cells of your baby. This makes the baby anemic and can result in severe heart and liver problems and even death of the baby if untreated. Once your body produces these antibodies or is “sensitized,” you are sensitized for life and your body will always react in this manner.

The good news is that this condition can be prevented with routine screening. If the mother is not sensitized, Rh-immune globulin can be given at 28 weeks to prevent the problem. If the mother is already sensitized, careful medical monitoring and treatment can begin. With early care, screening, and follow-up by your doctor, possible complications from this condition should be controlled.

In addition, your doctor will screen your blood for evidence of other, rarer blood group incompatibilities that can have similar effects on the pregnancy and the newborn.

Rh negative pregnancy treatment

So what do you do if you are pregnant and your rhesus is negative?

First and most important: See your doctor or health care provider as soon as you think you are pregnant and continue your routine prenatal checkups to monitor your progress.

Follow your doctor’s advice for blood typing, Rh determination, and antibody screening. If you are Rh negative and show no antibodies in your blood at 28 weeks of pregnancy, your doctor should give you a dose of Rh-immune globulin. If your baby is Rh positive, you can expect to receive another dose within 72 hours after delivery of your baby. This will prevent this condition from occurring in future pregnancies.

When your doctor or health care provider takes your prenatal health history, be sure to mention any previous pregnancies ending in abortion or miscarriage that also could generate the antibodies in your body if you are negative and that fetus was positive.

If tests show that you are pregnant now and have been sensitized with a previous pregnancy, your doctor may periodically re-evaluate the status of the baby during the second half of your pregnancy through blood tests and amniocentesis. If these tests show that your baby is endangered, your doctor will initiate additional medical treatment.

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