Rh Factor Like The Blood Types example essay topic

Rh Factor Incompatibility and How it Affects a Pregnant Mother and Her Fetus or Newborn Rh incompatibility is a condition that occurs when the mother of a fetus or a newborn has Rh-negative blood type and the fetus or newborn has Rh-positive blood. This incompatible blood reaction may cause progressive problems in a newborn as well as life-threatening problems for future pregnancies. What is the Rh Factor? Rh factor is a protein present in red blood cells. Proteins called antigens on the surface of the red blood cell (RBC) determine the type of blood you have (Ackley and Ladwig 98). There are four major blood types: A, B, AB, and O. There are two antigens, A and B. When A antigen is present, you have Type A blood.

If you have the B antigen on the RBC, then you have the Type B blood. When both A and B antigens are present, you have Type AB blood. When neither are present, you have Type O blood. When an antigen is present on the RBC, then the opposite antibody is present in the plasma. For instance, Type A blood has anti-Type-B antibodies. Type B blood has anti-Type-A antibodies.

Type AB has no antibodies in the plasma, and Type O blood has both anti-Type-A and anti-Type-B antibodies in the plasma. These antibodies are not present at birth but are formed spontaneously during infancy and last throughout life. In addition to the ABO blood group system, there is an Rh blood group system. There are many Rh antigens that can be present on the surface of the RBC. The D antigen is the most common Rh antigen. If the D antigen is present, then that blood is Rh+.

If the D antigen is missing, then the blood is Rh-. This Rh factor is connected to a person's blood type. For example, your blood may be AB+ which means that you have Type AB blood with a positive Rh factor. Unlike the ABO system, the corresponding antibody antigen does not develop spontaneously but only when the Rh-person is exposed to the antigen by blood transfusion or during pregnancy. Who is Affected by This Disease?

Rh factor, like the blood types, A, B, and O, is inherited from one's parents. Through a simple blood test, blood type and the presence of the Rh factor can be determined. About 85% of white Americans, 95% of African Americans, and 99% of Chinese have the Rh protein in their blood (Sahagun 1). People easily inherit it because its presence is dictated by a dominant gene. The Rh factor affects about one in a hundred pregnancies. Rh factor is important only during a pregnancy in which an Rh-negative woman is carrying an Rh-positive fetus.

This can occur when an Rh-negative woman conceives a baby with an Rh-positive man. The gene for Rh-positive blood is dominant over the gene for Rh-negative blood, so their baby will be Rh positive. If the Rh-positive father also carries the gene for Rh-negative blood, his children have a 50% chance of inheriting Rh-negative blood and a 50% chance of inheriting Rh-positive blood. If both parents are Rh negative, their offspring will be Rh-negative.

What is Going on in the Body? The incompatibility exists when the mother and the fetus do not share the same Rh factor. Seeping into the circulatory system of the fetus through the ruptures on the membrane, the mother's blood comes into contact with the child's. This in turn signals the mother's immune system to produce antibodies if the mother and the fetus do not share the same positive or negative Rh factor. The mother's body will then treat the fetus as a foreign substance in the body and produce antibodies to destroy the Rh protein and the red blood cells to which it was attached, in this case, the fetus. What are the Signs and Symptoms of the Disease?

Rh incompatibility can cause symptoms ranging from very mild to fatal. In a mild case the fetus suffers from anemia. In some cases it can cause an enlargement of the spleen and liver. Congestive heart failure can occur in severe cases to the fetus. Once born, the infant may also experience problems from the large amounts of red blood cells produced while combating the mother's antibodies. An infant with Rh factor may have the appearance of jaundice due to the liver and spleen not filtering the blood properly.

In a more severe case the infant would experience abnormal drowsiness, suck poorly, and have muscle spasms. The abundance of red blood cells circulating in the baby's body can also cause a toxic or poisonous effect in which it breaks down bilirubin, which may lead to brain damage, deafness, mental retardation, or death. What are the Causes and Risks of the Disease? Rh incompatibility occurs when a woman has Rh-negative blood and a man who has Rh-positive blood conceive a baby who is Rh-positive. There is generally no risk to the first baby but, rather, to future babies in that family who have Rh-positive blood. Previous abortions or stillbirths of a fetus that had Rh-positive blood may present a risk to a woman who is Rh-negative.

This exposure to Rh-positive blood may be enough to cause her body to make antibodies to the Rh factor. Any future Rh-positive babies she may conceive therefore may be at risk. What can be Done to Prevent the Disease? Rh incompatibility can be prevented by giving women an injection of something called Rho immune globulin. It is unclear exactly how Rho immune globulin works. It is thought to prevent the woman from developing antibodies to the Rh factor.

If a woman does not develop these antibodies, then there may be little risk to any future Rh-positive babies she may have. This therapy may be given just before a woman delivers her Rh-positive baby or immediately afterward. Some women may be given it both times if the healthcare providers feels it is necessary. How is the Disease Diagnosed? This disease can be diagnosed early in the pregnancy during a prenatal checkup. A blood test is given to determine the main blood group and Rh status to assist in maternal care (Ingalls and Salerno 68).

This will be used in the event of hemorrhage and to detect the possibility of blood protein incompatibility. Blood is also drawn from the father and tested. If the Rh incompatibility exists, tests on the amounts of antibodies in the mother's blood stream will be taken at the initial visit and also at 24, 28, 32, and 36 weeks of gestation. What are the Treatments for the Disease?

Tests of the amniotic fluid, the fluid that surrounds the fetus during pregnancy, can be done to see if there are Rh antibodies. If testing proves the Rh protein is in the mother's blood, then RhoGam is given. RhoGam is plasma from human donors immunized to produce high levels of antibodies against the Rh antigen. This is usually given at 28 weeks' gestation as well as after amniocentesis and birth. Treatment of the already affected infant depends on the severity of the condition, but prevention is the best treatment. Rh factor is a dangerous disease in which the mother's body may actually produce antibodies to destroy or harm the fetus.

What are the Treatments to the Already Affected Fetus or Newborn? If the fetus is suffering from anemia and forcing out into his blood stream dangerous amounts of immature and inadequate forms of red blood cells, then an intrauterine blood transfusion may be necessary. This is not done without risk but may be considered when no other hope for the fetus exists. Tests that may be performed on a newborn include a test for Rh antibodies and a blood count from the cord blood. Scans to evaluate the function of the heart, liver, spleen, and brain may also be recommended. After birth, an exchange transfusion may be needed.

The Rh protein blood is slowly withdrawn and replaced with negative donor blood. An infant with jaundice may be placed near fluorescent light to reduce the amount of circulating bilirubin. Another condition is when high levels of bilirubin build up in the brain. This leads to serious brain damage.

What are the Long-Term Effects of the Disease? Rh incompatibility is a dangerous disease in which the mother's body treats the fetus as a foreign substance because of the Rh protein in the blood and then produces antibodies to destroy it. The long-term effects of Rh incompatibility depend on whether the woman was given RhoGam or any other treatment during the pregnancy. The infants that do survive may suffer from severe nerve problems including cerebral palsy and mental retardation.

Infants who developed more severe Rh reactions and are untreated may suffer severe nerve or brain damage, requiring life-long treatment with therapy to adjust to the world physically, mentally, and medically. Also, these infants may have swelling of tissues and organs in the body that can lead to death. When severe Rh incompatibility goes untreated, many infants die at a very early age. Conclusion The Rh factor, a blood protein, plays a critical role in some pregnancies. About 85% of white Americans, 95% of African Americans and 99% of Chinese people have the Rh protein in their blood. Because a dominant gene dictates its presence the Rh factor affects about one in a hundred pregnancies.

The incompatibility exists when the mother and the fetus do not share the same Rh factor such as when a woman who lacks the Rh protein in her blood has a baby with a man who is Rh positive and the baby inherits the father's Rh positive blood. Her body will produce antibodies to destroy the Rh protein and the red blood cells to which it was attached, in this case the fetus. Rh incompatibility can cause symptoms raging from very mild to fatal. Some mild cases would be anemia or an enlarged spleen and liver. The more severe case would be congestive heart failure, mental retardation, brain damage or death. RhoGam shots can be given to the mother or blood transfusions to the fetus or infant as treatment.

Pregnant mothers should have a prenatal check-up to protect her and her child from the devastating effects of Rh-incompatibility. As with most diseases early prenatal check-ups are essential in preventing and treating the Rh Incompatibility factor. GLOSSARY Anemia: a decrease in red blood cells usually characterized by paleness and lack of energy. Antibody: any of a class of blood proteins serving to immunize the body against specific antigens. Antigen: a substance that induces the manufacture of antibodies. Bile: a bitter yellow or greenish liquid secreted by the liver.

Bilirubin: orange to yellowish pigments in bile that is a by-product of the breakdown of red blood cells. Jaundice: a diseased condition of the liver due to the presence of bile pigments in the blood and characterized by yellowness of the skin and eyeballs. Plasma: clear fluid portion of blood, freed from blood cells and used for transfusions. Stillbirth: a fetus dead at birth.

Bibliography

Ackley, Linda, and John Ladwig, Nursing-A Guide to Diagnosis Handbook. St. Louis: Mosby -Yearbook, 1993: 95-98.
Dorland, Irene. Dorland's Illustrated Medical Dictionary. Philadelphia: Saunders Co., 27th Edition, 1998.
Ingalls, Sharon, and Beth Salerno. Maternal and Child Health Nursing. St. Louis: Mosby-Yearbook, 7 thE dition, 1991: 68.
Sahagun, Christopher A. "One and the Same". 1998.
Online 15 February 2003.