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Patient education: Pregnancy in Rh-negative people (The Basics)

Patient education: Pregnancy in Rh-negative people (The Basics)

How do I know my blood type? — Your blood type has 2 parts:

Your "ABO blood group" – This means whether your blood is type A, B, AB, or O.

Your "Rh blood group" – This means whether your blood is "Rh-positive" or "Rh-negative."

If you are pregnant, you will get blood tests at your first prenatal visit. This includes a test to check your blood type.

What does "Rh-negative" mean? — "Rh" is the name of a protein that can be found on red blood cells. People who have this protein have an "Rh-positive" blood type. People who do not have this protein have an "Rh-negative" blood type, for example, "type O negative."

Having an Rh-positive or Rh-negative blood type does not affect your health. But problems can happen during pregnancy if you have Rh-negative blood and your baby has Rh-positive blood. The medical term for this is "Rh incompatibility." Luckily, there is a medicine that usually prevents these problems.

The following information is for people with an Rh-negative blood type. If you have Rh-positive blood, the information does not apply to you.

What problems can happen if I have Rh-negative blood? — Certain problems can happen if you have Rh-negative blood and the baby in your uterus has Rh-positive blood:

Usually, during pregnancy, your blood does not mix with your baby's blood. But sometimes, it does.

If a small amount of the baby's blood gets into your bloodstream, your immune (infection-fighting) system recognizes the blood as being different from yours. This causes it to make proteins called "antibodies." The most common time for the baby's blood to get into your bloodstream is during birth. But sometimes, it happens before labor begins.

If you get pregnant again in the future, these antibodies can cross the placenta and attack the baby's red blood cells. This can cause a condition called "anemia," which is when a person has too few red blood cells. If this happens, the baby can make more red blood cells, but sometimes not enough to prevent anemia.

How do I know my baby's blood type? — Sometimes, it's hard to know before the baby is born. If you know your baby's father's blood type, you might know your baby's blood type:

If both you and the baby's father have Rh-negative blood, your baby will have Rh-negative blood, too.

If your baby's father has Rh-positive blood, your baby could have Rh-negative or Rh-positive blood. But if you have Rh-negative blood, the doctor or midwife will treat your baby as if they have Rh-positive blood. That way, any possible problems can be prevented.

It is also possible to figure out your baby's Rh blood type before birth by doing a test on your blood. But this test is not done everywhere, and your insurance might not cover it.

What happens next? — If you are Rh-negative, your doctor or midwife will do certain blood tests during pregnancy. These tests check whether you have antibodies in your blood that could cause anemia in your baby.

If you do not have antibodies in your blood and your baby is (or could be) Rh-positive, your doctor or midwife will give you medicine. This medicine prevents your body from making antibodies that could attack your baby's red blood cells. This can prevent anemia or other problems.

The medicine is called "anti-D immune globulin" (sample brand name: RhoGAM). It usually comes as a shot. You will get it during your third trimester.

After your baby is born, the doctor will do a blood test on the baby to check their blood type. If your baby is Rh-positive, your doctor will give you another dose of anti-D immune globulin soon after birth. If your baby is Rh-negative, you do not need another dose.

People who are Rh-negative might also get anti-D immune globulin at other times, for example, if they:

Have vaginal bleeding during pregnancy

Have a test during pregnancy called "amniocentesis" or "chorionic villus sampling"

Have a pregnancy loss (miscarriage), which is when a pregnancy ends on its own before the baby can live outside of the uterus

Have an abortion to end a pregnancy

Have an ectopic pregnancy, which is a pregnancy that grows somewhere other than in the uterus

What happens if I already have antibodies in my blood? — If you already have antibodies in your blood, anti-D immune globulin will not help. Your doctor will not give you this medicine. But they will do different tests to monitor your baby during pregnancy. If anemia or other problems happen, your doctor will talk with you about possible treatments.

What if I get pregnant again? — If you get pregnant again, you will need treatment again. Rh-negative people are treated with anti-D immune globulin during each pregnancy, as long as they don't have antibodies in their blood.

More on this topic

Patient education: Prenatal care (The Basics)
Patient education: Amniocentesis (The Basics)
Patient education: Chorionic villus sampling (The Basics)
Patient education: Pregnancy loss (The Basics)
Patient education: Bleeding in early pregnancy (The Basics)
Patient education: Abortion (The Basics)
Patient education: Ectopic pregnancy (The Basics)
Patient education: Blood type test (The Basics)

Patient education: Amniocentesis (Beyond the Basics)
Patient education: Chorionic villus sampling (Beyond the Basics)
Patient education: Pregnancy loss (Beyond the Basics)
Patient education: Abortion (pregnancy termination) (Beyond the Basics)
Patient education: Ectopic (tubal) pregnancy (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
Disclaimer: This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms. 2024© UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.
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