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Blood Type and Pregnancy
January 2003

Q. I have one child and was told during the pregnancy that I am Rh negative and sensitized and never received RhoGAM. I don't know if this will help any, but my doctor said that 1:16 is considered critical for an antibody titer and I remember mine being much higher. I was told to not have any more children without having intrauterine blood transfusions during the pregnancy. How successful is this procedure and what can I expect? What will the health of the baby be like having this procedure?

A. The red blood cells carry oxygen to all organs of the body, and remove carbon dioxide, the by-product of metabolism. The red cells can be classified by blood type (A,B,AB, and O) and also by Rh status (positive or negative) based on proteins found on the surface of these cells. These proteins determine the blood type of a baby based on parental blood type, and also compatibility for transfusion.

For example, a person who is Rh-negative will recognize Rh-positive blood as foreign, and antibodies will be formed to attack those Rh-posivite cells. This does not usually cause problems in a first pregnancy, but if an Rh-negative mother is sensitized, her immune system will attack the red cells of an Rh-positive pregnancy in a subsequent pregnancy.

This situation requires careful monitoring and can result in the need for a transfusion to the fetus to protect it from severe and even fatal consequences. It can be quite successful, but requires cautious and skilled medical care.

http://www.nlm.nih.gov/medlineplus/ency/article/001600.htm

http://cpmcnet.columbia.edu/texts/gcps/gcps0048.html

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