Pregnancy-Rh issue

Patient

Q: I just got pregnant for the second time, the first one was an abortion using cytotec tablets. The problem is I am Rh negative and my husband is Rh positive... after the abortion I didn't take the anti-Rh injection because i had no idea about it... now I'm 11 weeks pregnant... I know now that I might have antibodies against my babies bloood.... what can i do????? I live in Egypt

Doctor

A:   I understand your concern about Rh incompatibility. As you already know, you might have probably already developed antibodies for Rh factor.
In the second or later pregnancies, your Rh antibodies might recognize the Rh proteins on the surface of the baby's blood cells as foreign, and pass into the baby's bloodstream and attack those cells. This can lead to swelling and rupture of the baby's RBCs. A baby's blood count can get dangerously low when this condition, known as or , occurs.
Now since you didn’t receive your Rhogam shot, your next pregnancy must be closely monitored to make sure that those levels are not too high. In rare cases, if the incompatibility is severe and the baby is in danger, a series of special blood transfusions (called exchange transfusions) can be performed either while the baby is still in the uterus or after delivery.
Exchange transfusions replace the baby's blood with RBCs that are Rh-negative. This procedure stabilizes the baby's level of red blood cells and minimizes further damage caused by circulating Rh antibodies already present in the baby's bloodstream. I wish you a successful pregnancy.

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