Introduction
Something as simple as knowing your blood type could make a life-saving difference for your baby. In some cases, unexplained miscarriages or pregnancy complications may be linked to a condition called Rh incompatibility, a risk that often goes unnoticed until it’s too late.
The good news is, with awareness, regular monitoring, and timely medical care, Rh incompatibility can be managed, and mothers can go on to deliver healthy babies.
This blog covers everything you need to know about the Rhesus (Rh) factor, how Rh incompatibility affects the baby, and how it can be diagnosed and treated during pregnancy.
What is the Rh Factor?
Every person has a blood type (A, B, AB, or O) and a Rhesus factor or Rh, which is a protein found on red blood cells. If you have that Rh protein in your blood, you are Rh positive or a positive blood group such as A+, B+, and so on. Whereas if you lack that protein in your blood, you are Rh negative or you belong to a negative blood group such as O-, B-, etc.
Did you know? Researchers say that around 5-6% of the Indian population is Rh negative. Meaning, 5-6% of the world population lack the tiny Rh protein in their blood.
Source: Link
What is Rh Incompatibility?
Rh incompatibility is a condition during pregnancy that can happen when the mother belongs to a negative blood group or is Rh negative and the father belongs to a positive blood group.
If the baby gets the same blood group as the mother, then there is no cause for concern. But if the baby gets the positive blood group from the dad, it means the mother and the baby are Rh incompatible.
When do Rh incompatibility occur?
| Mother’s Blood Type | Father’s Blood Type | Compatibility | Risk of Rh Incompatibility | What to Do? |
|---|---|---|---|---|
| Positive | Positive | Compatible | No | Routine prenatal care |
| Positive | Negative | Compatible | No | Routine prenatal care |
| Negative | Negative | Compatible | No | Routine prenatal care |
| Negative | Positive | 50% chance of Rh incompatibility | Yes. There is a 50% chance for the baby to inherit Rh-positive blood from the father, leading to Rh incompatibility | ICT test, Anti-D injection, more frequent monitoring |
Rh Incompatibility Risk Checker / Calculator
Rh Incompatibility Calculator
Is Rh incompatibility an issue during pregnancy?
Yes. When the mother and the baby are Rh incompatible, the mother’s body will start producing antibodies against her own baby and will start attacking the baby’s blood cells or the Rh protein in the baby’s body as the body thinks of it as a foreign object.
These antibodies can potentially lead to various complications in the baby including anemia or low red blood cells and liver issues as the liver or spleen needs to work harder for the body to produce red blood cells.
Risk factors to the baby
If the mother’s immune system starts attacking the baby’s red blood cells, it can lead to various complications in the baby including:
- Severe fetal anemia (low red blood count)
- Jaundice
- Hydrops fetalis (a serious condition where the baby’s body swells with fluid)
- Stillbirth (Loss of fetus after 20 weeks of pregnancy).
How Do We Detect Rh Incompatibility?
- Blood Group and Rh Typing
During routine prenatal checkups, blood grouping tests are done for all expectant mothers to find their blood types. If the mother is Rh negative or has a negative blood group, the blood test of the father is taken to find his blood group. If the father is Rh positive or has a positive blood group, further rounds of tests are done.
2. ICT – Indirect Coombs Test
This is a blood test that checks if the mother’s body has already started producing antibodies against the baby’s red blood cells. If ICT is negative, it means the baby hasn’t started to produce those antibodies yet. But it doesn’t mean that the body won’t produce it. It just hasn’t produced those yet. In those cases, an injection called Anti-D is given to the mother to prevent the production of those antibodies.
If the ICT is positive, it means the mother’s body has already produced those antibodies and the baby is already at risk. This condition requires further tests to help ensure the well-being of the fetus.
Antibodies are present – we need to monitor the baby closely for signs of anemia. We repeat the ICT test regularly during pregnancy if you’re Rh-negative to ensure the wellbeing of the baby.
How to Interpret ICT Results in Rh-Negative Pregnancies?
| ICT Result | Interpretation | Risk to the baby | Next steps |
|---|---|---|---|
| Positive | The mother’s body has already started producing antibodies against the baby’s red blood cells. | The baby is already at risk as the mother’s antibodies have started attacking the baby’s red blood cells. | MCA Doppler scan to monitor the baby closely and detect signs of fetal anemia. |
| Negative | No antibodies against Rh detected | No immediate risk. | Frequent monitoring and Anti-D injection at 28 weeks to prevent the production of antibodies against Rh. |
How to detect if the baby is at risk?
If antibodies are detected in the mother’s blood, we monitor the baby closely using ultrasound scan called MCA Doppler.
MCA Doppler Scan (Middle Cerebral Artery Doppler)
This is a safe, non-invasive ultrasound that checks the baby’s brain blood flow to rule out anemia. If the blood flow is faster than normal, it is a sign of anemia.
Once a mother has ICT positive, MCA Doppler is done every alternate week to closely monitor the baby.
What if there are signs of Anemia?
If the MCA reveals signs of anemia, IUT or intrauterine blood transfusion is done when the baby is still in the womb in order to control anemia.
Rh Incompatibility Treatment
When the mother and the baby are Rh incompatible, doctors run a test called ICT (Indirect Coombs Test) to check if the mother’s body has started producing antibodies against the baby’s red blood cells. In most first pregnancies, the mother’s body would not have started producing it. And by the time the antibodies are produced, the baby will be delivered, so that baby is safe.
But for some mothers, the body might have already started producing those antibodies even in first pregnancies. In that case, anemia is one of the most common complications observed.
In order to treat the baby, a procedure called Intrauterine blood transfusion is carried out while the baby is still in the womb. It is a complex and delicate procedure.
It involves anesthetizing the baby and carefully transfusing blood at a slow, controlled pace. In most cases, more than one transfusion is needed—typically spaced 4 to 5 weeks apart—because the mother’s antibodies continue to attack the baby’s red blood cells over time. This ongoing immune response makes close monitoring and repeated intervention essential to protect the baby’s health.
Conclusion
Rh incompatibility is a serious yet manageable condition with early intervention and proper care. It is crucial for couples planning to have a baby to opt for prenatal counseling and comprehensive prenatal screening to understand their health conditions.
This helps ensure the well-being of the baby and supports a safe, healthy pregnancy.
If you have a negative blood group and are trying to conceive, make sure to consult with a fetal medicine specialist beforehand to be fully prepared for any potential outcomes. At Jammi Scans, we have helped a lot of mothers with Rh incompatibility to give birth to healthy babies.
Early intervention and timely management are what make all the difference. Ensure you get your full body checkup done before planning for pregnancy to ensure safer pregnancy and childbirth.
Why Choose Jammi Scans?
- Jammi Scans is led by renowned fetal medicine specialist Dr. Deepthi Jammi, who is highly experienced in managing high-risk pregnancies, including Rh incompatibility.
- At Jammi Scans, we have helped hundreds of mothers with Rh incompatibility go on to deliver healthy babies.
- We work closely with your gynecologist and monitor the baby’s well-being closely through MCA Doppler scans.
