| Maladie hémolytique Rhésus | M | Maladie hémolytique Rhésus | Rhesus hemolytic disease | | French | Pregnancy | Adult (19+) | Body | Reproductive system | Conditions and diseases | Prenatal
Adult (19+) | NA | | 2009-09-11T04:00:00Z | | | | | | 11.0000000000000 | 50.0000000000000 | 473.000000000000 | | Flat Content | Health A-Z | <p>Apprenez ce qu’est l’incompatibilité Rh et la maladie Rh associées à la grossesse, y compris la prévention de la maladie Rh et ce à quoi il faut s’attendre pendant la grossesse.</p> | <p>Le facteur Rhésus (Rh) est un groupe de protéines présent à la surface des globules rouges. Si vous avez un facteur Rhésus sur vos globules rouges, vous êtes Rh positif. Si vous n’avez pas de facteur Rhésus, vous êtes Rh négatif. On parle d’incompatibilité Rh lorsqu’une femme Rh négatif tombe enceinte d’un bébé Rh positif. Advenant que les globules rouges Rh positifs du bébé en gestation traversent le placenta et parviennent au sang de la mère, le système immunitaire de celle-ci produira des anticorps qui détruiront les globules rouges du bébé. C’est alors que l’on parle d’une complication appelée maladie hémolytique Rh du bébé en gestation. </p> | <h2>À retenir</h2>
<ul><li>Une incompatibilité Rh se produit lorsqu’une mère Rh négative devient enceinte d’un bébé Rh positif, ce qui peut causer une maladie hémolytique Rh.</li>
<li>Les femmes qui sont Rh-négatives reçoivent une injection d’immunoglobuline Rh pendant et après leur grossesse afin de bloquer leur système immunitaire et ne pas nuire au fœtus.</li>
<li>Si le fœtus montre des signes de maladie hémolytique Rh, il peut être nécessaire de provoquer un travail précoce afin que les anticorps de la mère ne détruisent pas un nombre trop important des globules rouges du fœtus.</li></ul> | | | | | | | | | | | | | | | | | | | | | | | | | |
| Hemolytic disease of the fetus and newborn (HDFN): Rhesus (Rh) disease and other non-ABO antibodies | H | Hemolytic disease of the fetus and newborn (HDFN): Rhesus (Rh) disease and other non-ABO antibodies | Hemolytic disease of the fetus and newborn (HDFN): Rhesus (Rh) disease and other non-ABO antibodies | | English | Pregnancy | Adult (19+) | Body | Reproductive system | Conditions and diseases | Prenatal
Adult (19+) | NA | | 2023-03-17T04:00:00Z | | | | | | 11.6000000000000 | 46.6000000000000 | 694.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Learn about Rh incompatibility and Rh disease during pregnancy, including prevention of Rh disease and what to expect during pregnancy.</p> | <div class="pdf-page-break"></div><h2>What is hemolytic disease of the fetus and newborn? </h2><p>Hemolytic disease of the fetus and newborn (HDFN) is a blood disorder in which the baby’s red blood cells break down quickly, known as hemolysis. This causes the release of a breakdown product, bilirubin, into the baby’s bloodstream as well as the destruction of the red blood cells in the baby’s body. </p><h2>Blood groups</h2><p>A person’s
<a href="/article?contentid=1578&language=english">blood group (or blood type)</a> is classified based on special antigens on the surface of the red blood cell. The antigens are made of proteins, carbohydrates and/or lipids and vary from person to person. These antigens are inherited by our genes. There are many different antigens on a person’s red blood cells. A small number of these can cause HDFN if they do not match between mother and baby.</p><p>There are four major blood groups: A, B, AB, and O. </p><p>A person’s red blood cells may also contain a protein called the Rhesus (Rh) factor. </p><ul><li>If a person has the Rh factor, they are RhD positive (Rh+). This is sometimes referred to as a 'positive blood group'. </li><li>If they do not have the Rh factor, they are RhD negative (Rh-), or a 'negative blood group'. </li></ul><p>There are many more blood groups beyond the "ABO system" or the "Rh +/- system", however these are the most commonly discussed blood groups.</p><p>All babies inherit their blood group from both parents. Sometimes, the baby will have a blood group from their father which is different from their mother. </p>
<figure class="asset-c-80">
<span class="asset-image-title">Rh factor inheritance: Example 1</span><img src="https://assets.aboutkidshealth.ca/akhassets/Rh_inheritance_1_MED_ILL_EN.jpg" alt="Chart of chromosomal distribution from an Rh-positive father, with two Rh-positive chromosomes, and an Rh-negative mother" /><figcaption class="asset-image-caption">In this example, the father is Rh-positive and the mother is Rh-negative. All the children of this couple will inherit the dominant Rh+ allele from their father and will be Rh-positive. The mother should be given Rh immunoglobulin injections during all her pregnancies.</figcaption></figure><figure class="asset-c-80"><span class="asset-image-title">Rh factor inheritance: Example 2</span><img src="https://assets.aboutkidshealth.ca/akhassets/Rh_inheritance_2_MED_ILL_EN.jpg" alt="Chart of chromosomal distribution from a father with one Rh-positive chromosome and one Rh-negative and an Rh-negative mother" /><figcaption class="asset-image-caption">In this example, the father is Rh-positive and the mother is Rh-negative. The children of this couple may be either Rh-positive or Rh-negative, depending on which gene copy they inherit from their father. The mother should be given Rh immunoglobulin during pregnancy as a precaution.</figcaption></figure>
<p>If the baby’s blood group is different from the mother’s, the mother’s immune system may then develop antibodies targeting the different blood group that is on her baby’s red blood cells, but not hers. </p> | <h2>Key points</h2><ul><li>Hemolytic disease of the fetus and newborn (HDFN) causes a fetus or newborn baby’s red blood cells to break down more quickly than they should. This occurs due to differences in blood type between mother and baby.</li><li>When there is a difference between the mother’s blood type and the baby’s blood type, the mother’s immune system can react and can cause the baby’s red blood cells to break down.</li><li>The breakdown of red blood cells causes anaemia, too little blood (also known as low hemoglobin) and an increase in bilirubin, which causes jaundice, often seen as a yellow discolouration of the skin. </li><li>This process begins during pregnancy and can cause ongoing problems for weeks to months after birth. Babies need to be monitored regularly for at least 6-8 weeks, even if no active treatment was initially required when the baby was born.</li><li>Some cases of HDFN are mild and might not need any treatment, while others can be severe and need a lot of monitoring and treatment. </li><li>Most babies with this condition will have no long-term problems, if recognized and treated early. </li></ul> | | <h2>What causes HDFN?</h2><p>HDFN can occur when the baby and the mother’s blood group do not match. The mother’s immune system then develops antibodies against the baby’s blood group. </p><p>A mother’s bloodstream has many circulating antibodies. Antibodies are proteins which act in the immune system. Many antibodies are used to fight infection, while others can target other parts of the body including the antigens on red blood cells. </p><p>If a mother has specific antibodies against the baby’s blood group, the antibodies can travel across the placenta into the baby’s bloodstream. These antibodies can still be active in the baby’s blood stream for weeks to several months after birth. The antibody can attach to the baby’s red blood cells and destroy them, which leads to HDFN. In types of HDFN caused by non-ABO antibodies, this red blood cell destruction can happen before delivery, after delivery, or both. </p><p>A mother can develop new blood type antibodies when there is mixing of the baby’s and the mother’s blood during pregnancy, or when the mother has been exposed previously to the part of the baby’s red blood cell that does not match. </p><p>This can be a previous blood transfusion, a previous miscarriage or a previous pregnancy, amongst other things. As there needs to be previous exposure, this type of HDFN rarely occurs in the first pregnancy. </p><h3>HDFN due to Rhesus (Rh) disease</h3><p>Often the most serious type of HDFN is Rhesus (Rh) disease. This usually occurs when the mother is RhD negative and the baby is RhD positive, and the mother has developed an antibody to RhD from a previous exposure to RhD positive blood. </p><p>Rh disease does not typically occur in the first pregnancy. However, exposure during the first pregnancy can create significant risk for the next pregnancy and baby. Sometimes there has been an unidentified previous miscarriage which caused exposure, and thus the first known pregnancy is affected. See below for details of how to prevent Rh disease in future pregnancies. </p>
<h3>HDFN due to other non-ABO antibodies</h3><p>Antibodies can develop less commonly against many other red cell antigens, which can also cause HDFN. In addition to RhD, more severe disease can occur due to Kell and c antibodies. HDFN has been described due to at least 40 other red blood cell antibodies that occur less commonly. </p><h2>What are the risks to my newborn? </h2><p>Often babies affected by this condition need monitoring before they are born, as they are at risk of <a href="/article?contentid=841&language=english">anaemia</a>. If the antibody is identified during the pregnancy, and is of a high level, you will be referred to a health-care team to monitor the baby and potentially treat any anaemia. Your team will talk to you about this. </p><p>Newborn babies are at risk of developing anaemia from the destruction of their red blood cells. Anaemia is when a person has too few red blood cells, also known as low hemoglobin. People need red blood cells to carry oxygen and provide energy to parts of their body, including their heart and brain. Anaemia is life threatening if the red blood cells are too low. Anaemia can develop before birth in severe cases. </p><p>Newborn babies can also develop <a href="/article?contentid=775&language=english">jaundice</a>, which is caused by the breakdown product of red blood cells (bilirubin). Jaundice does not develop in babies before birth as the mother’s blood circulation clears the bilirubin quickly. </p><p>Jaundice is often seen as yellowing of the skin and eyes in the newborn baby. </p><p>Very high levels of bilirubin are toxic to the developing brain and can cause a condition known as kernicterus. Kernicterus is damage to the brain’s nerve cells and can cause neurological consequences such as hearing loss and cerebral palsy. This is why treatment is initiated quickly to lower bilirubin levels. Kernicterus is very rare, due to early recognition of risk factors and bilirubin testing. </p> | | <h2>How is HDFN treated after a baby is born?</h2><p>After the baby is born, symptoms can range from mild jaundice to severe jaundice and severe anaemia. The baby will have blood tests repeated over several days to determine how the hemolysis is progressing (assessing bilirubin levels and hemoglobin levels if necessary). </p><p>Depending on the severity of the jaundice, determined by how elevated the bilirubin levels are, there are a few different treatment options. </p><ul><li>Phototherapy is the most common treatment required and uses a special lamp and/or blanket of blue light to help the baby’s body to get rid of the bilirubin. Phototherapy makes the molecules of bilirubin come together, allowing the kidneys to excrete them out of the body through urine. Usually, babies require this treatment for hours to days. </li><li>If jaundice is severe and phototherapy is not enough to treat it quickly, an exchange transfusion may rarely be needed. Exchange transfusions remove the blood with critically high bilirubin levels and replaces it with donated red blood cells. </li><li>If anaemia is severe, red blood cell transfusions are required. </li><li>Other therapies, including intravenous immunoglobulin (IVIg), a plasma-based blood product, can also be considered to dampen the immune process in some instances. </li></ul><p>Your health-care team will discuss these treatment options with you if they are needed for your baby. </p> | | <div class="pdf-page-break"></div><h2>When to seek medical attention </h2><p>Seek medical attention if your baby:</p><ul><li>develops more jaundice or is very pale</li><li>is very sleepy</li><li>is not feeding well</li><li>develops a high pitched cry</li><li>has any other concerns</li></ul> | | | | | | | | | | | | | | | | | | | |
