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Name: Pamela C.
Status: Student
Age: 30s
Location: N/A
Country: N/A
Date: 2002


Question:
I am Rh negative, and my husband is Rh positive, so when I became pregnant, I became interested in Rh incompatibility. Neither my obstetrician nor any of the medical books or hematology web sites I have looked at could answer the following: Why is ABO incompatibility less serious than Rh incompatibility? They are both just proteins on red blood cells that you can develop antibodies to, right? So why are the results of incompatibility so different? It is fine to give a technical answer.



Replies:
I am a registered Medical Technologist and I got out my Immunohematology text (blood banking). I could find no real good answer either. There were some hints, however. You probably know that the first child born to an Rh- mom and Rh+ dad usually shows no symptoms because the baby's blood cells are what is causing the mom to form antibodies. This usually does not happen until birth, when the placenta detaches and the mom's and baby's cells can mix. If you get anti-immune globulin ("the shot") within so many hours after birth this can find the baby's cells and inactivate them before your body knows they were there.

If this does not happen and you make antibodies to the baby's blood, your second child could be affected. You probably also know that if your husband is heterozygous (Rh+/Rh-) there is a 50% chance that each baby will be negative also. As far as why Rh is worse than ABO, what is your blood type? If you are type O, you have both anti-A and anti-B antibodies and there could be a reaction if the baby's cells mix with yours. There is also a possibility of ABO incompatibility between you and a child if you are, say, A and the baby is B. It does cause a mild hemolytic anemia in the baby, but I am told that a few days under the bilirubin lights usually takes care of this. Sorry I could not be of more help.

vanhoeck



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