Patient's question:
I am 13 weeks pregnant. I went to the hospital for a blood type test and found out that I am O positive. My husband's blood type is A positive. The doctor said that this blood type combination can easily lead to hemolytic disease of the fetus. What should I do now?First follow-up question: We do not have an Rh incompatibility issue. It's just that I am O positive and my husband is A positive, which could potentially lead to ABO hemolytic disease. So, I want to know what is the probability of having a hemolytic child in this situation? What should I do?
Doctor's answer:
Hello, Rh incompatibility between the mother and fetus can cause red blood cell destruction in the fetus, leading to fetal hemolytic disease. The most common type of hemolytic disease in Asian yellow races is ABO hemolytic disease, which is relatively familiar to everyone, while Rh incompatibility-induced fetal hemolytic disease is less known. Although the incidence of Rh hemolytic disease is low, once it occurs, the consequences are severe, potentially leaving permanent sequelae and even endangering the fetus's life. Some pregnant women have consulted whether they should be injected with drugs to prevent Rh hemolytic disease. A brief introduction is as follows:Rh blood type is divided into Rh negative and Rh positive. Most of the population in China is Rh positive, with only 1% being Rh negative, and it is even lower than 0.5% in Han Chinese. The proportion of white populations is around 15%.
Rh incompatibility occurs between a mother who is Rh negative and a fetus who is Rh positive.
Rh incompatibility hemolytic reactions often occur after the second pregnancy, accounting for about 99%. During the first pregnancy, the hemolytic reaction is relatively mild. When pregnant again, if the fetus is still Rh positive, the existing antibodies in the mother's body and the newly produced antibodies cause the fetal red blood cells to be continuously destroyed, which can lead to severe anemia and intrauterine death of the fetus. Survivors may develop severe jaundice, causing kernicterus, affecting the development of the brain and other vital organs, and leading to intellectual disabilities.
◎ Prevention measures for Rh hemolytic disease:
Administer Rh (D) IgG to Rh-negative pregnant women to prevent hemolytic disease.
1. After the first delivery of an Rh-positive infant, use it within 72 hours postpartum.
2. If the