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Patient ReportsRhesus Disease: Symptoms, Causes, Diagnosis and Treatment
Written by Medicover Team and Medically Reviewed by Dr Thajammul Samrin , Gynecologists
Table of Contents
Rhesus disease, also known as hemolytic disease of the fetus and newborn (HDFN), occurs when a pregnant woman has Rh-negative blood and the fetus has Rh-positive blood. The mother's immune system may produce antibodies that attack the baby's red blood cells.
Rhesus disease can cause complications such as anemia, jaundice and swelling in the baby. Severe cases may lead to heart failure, neurological damage or death without timely treatment. Screening during pregnancy and preventive treatment can significantly reduce the risk.
What Are the Types of Rhesus Disease?
Rhesus disease can vary in severity depending on the level of red blood cell destruction and the effects on the fetus or newborn. The main forms include:
- Mild Rhesus Disease: The baby may develop mild anemia or jaundice that requires monitoring and treatment after birth.
- Moderate Rhesus Disease: Greater destruction of red blood cells can cause significant anemia and jaundice, requiring treatments such as phototherapy or blood transfusion.
- Severe Rhesus Disease: Severe fetal anemia can lead to heart failure and widespread fluid accumulation, a condition known as hydrops fetalis.
- Rh Sensitization: This occurs when an Rh-negative person's immune system develops antibodies against Rh-positive red blood cells, increasing the risk of complications in a current or future pregnancy.
What Are the Symptoms of Rhesus Disease?
Symptoms of Rhesus disease mainly affect the fetus or newborn and can range from mild to severe. Some babies develop symptoms before birth, while others show signs shortly after delivery.
What Causes Rhesus Disease?
Rhesus disease is caused by incompatibility between the Rh blood types of a pregnant woman and her baby. It usually occurs when an Rh-negative mother carries an Rh-positive fetus and develops antibodies against the baby's red blood cells.
Maternal-Fetal Blood Group Incompatibility
When an Rh-negative mother is exposed to Rh-positive fetal blood, her immune system may recognise the Rh-positive cells as foreign and produce antibodies against them.
Previous Pregnancy With an Rh-Positive Baby
Exposure to Rh-positive blood during a previous pregnancy, miscarriage or delivery can cause sensitization. In a later Rh-positive pregnancy, maternal antibodies may cross the placenta and destroy the baby's red blood cells.
Previous Blood Transfusion
An Rh-negative person who previously received Rh-positive blood may develop antibodies that increase the risk of Rhesus disease during pregnancy.
Mixing of Maternal and Fetal Blood
Procedures or events that allow fetal blood to enter the mother's bloodstream can trigger sensitization. These may include abdominal trauma, bleeding during pregnancy, amniocentesis or other invasive procedures.
When Should You See a Doctor for Rhesus Disease?
Medical evaluation by an Obstetrician and Gynaecologist or Maternal-Fetal Medicine Specialist is important for pregnant women with Rh-negative blood, especially after bleeding, abdominal injury, or invasive procedures. Regular prenatal screening can identify Rh incompatibility and maternal antibodies early, allowing timely monitoring and treatment to protect the developing baby.
You should see a doctor if you have:
- Rh-negative blood and are pregnant or planning a pregnancy
- Vaginal bleeding or abdominal trauma during pregnancy
- A previous pregnancy affected by Rh incompatibility
Get medical help immediately if:
- The baby develops severe jaundice, poor feeding or unusual lethargy
- The newborn has difficulty breathing or significant swelling
- Reduced fetal movement or other concerning pregnancy symptoms occur
These could be signs of a serious complication like severe Rhesus disease, which needs urgent care.
How Is Rhesus Disease Diagnosed?
Rhesus disease is diagnosed through blood tests during pregnancy and tests that assess the baby's health. Early diagnosis helps doctors determine whether the mother has developed Rh antibodies and whether the fetus is affected by anemia.
Blood Tests for Rh Antibodies
Blood tests determine the mother's Rh status and check for antibodies against Rh-positive red blood cells. Antibody levels may be monitored throughout pregnancy if sensitization has occurred.
Ultrasound Scan
Ultrasound imaging can assess the baby's growth and look for signs of severe anemia, heart strain or abnormal fluid accumulation.
Amniocentesis
In selected cases, amniocentesis may be used to obtain additional information about the baby's condition. The need for this test depends on the individual pregnancy.
Cordocentesis
Cordocentesis, also known as percutaneous umbilical blood sampling, may be performed in severe cases to directly measure the baby's blood count and assess fetal anemia.
How Is Rhesus Disease Treated?
Treatment for Rhesus disease depends on whether the mother has developed Rh antibodies and how severely the fetus or newborn is affected. Management may include preventive injections, close monitoring, fetal blood transfusions and specialised neonatal care.
Anti-D Immunoglobulin Therapy
Anti-D immunoglobulin is given to eligible Rh-negative pregnant women to prevent the immune system from producing antibodies against Rh-positive blood cells. It may be given during pregnancy, after delivery and following events that could cause maternal and fetal blood to mix.
Monitoring During Pregnancy
Regular blood tests and ultrasound examinations help doctors monitor maternal antibody levels and check the fetus for signs of anemia or other complications.
Intrauterine Blood Transfusion
In severe cases, blood may be transfused to the fetus through the umbilical cord to treat significant anemia and reduce the risk of serious complications.
Early Delivery
If the baby's condition worsens and the pregnancy has reached an appropriate stage, early delivery may be recommended so that treatment can continue after birth.
Neonatal Care
Newborns affected by Rhesus disease may require specialised care, including phototherapy for jaundice, blood transfusions, exchange transfusion or other supportive treatments.
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What Are the Risk Factors for Rhesus Disease?
The risk of Rhesus disease increases when an Rh-negative mother is exposed to Rh-positive blood and becomes sensitized. Important risk factors include:
- Rh-negative mother carrying an Rh-positive baby
- Previous pregnancies with Rh-positive babies
- Previous blood transfusions with Rh-positive blood
- Previous miscarriage, abortion or ectopic pregnancy
- Bleeding or abdominal trauma during pregnancy
- Invasive prenatal procedures such as amniocentesis
- A previous pregnancy affected by Rhesus disease
What Are the Complications of Rhesus Disease?
Without appropriate monitoring and treatment, Rhesus disease can cause serious complications due to the destruction of the baby's red blood cells.
- Severe anemia
- Jaundice
- Enlarged liver and spleen
- Heart failure
- Hydrops fetalis
- Brain damage caused by very high bilirubin levels
- Stillbirth or newborn death in severe untreated cases
Can Rhesus Disease Be Prevented?
Rhesus disease can often be prevented by identifying Rh-negative women early in pregnancy and providing anti-D immunoglobulin when appropriate. Regular prenatal care and timely treatment after possible exposure to Rh-positive blood are essential.
- Attend recommended prenatal appointments and blood tests
- Receive anti-D immunoglobulin as advised during pregnancy
- Receive preventive treatment after delivery of an Rh-positive baby
- Inform a healthcare provider about bleeding, miscarriage or abdominal trauma during pregnancy
- Follow medical advice after invasive prenatal procedures
Frequently Asked Questions
1. What is Rhesus Disease?
Rhesus Disease, also known as Rh disease, is a condition where a pregnant woman's immune system attacks the red blood cells of her baby if the mother is Rh-negative and the baby is Rh-positive.
2. How does Rhesus Disease affect pregnancy?
Rhesus Disease can lead to severe complications in the baby, including anemia, jaundice, and in severe cases, brain damage or even death if left untreated.
3. How is Rhesus Disease diagnosed?
Rhesus Disease can be diagnosed through blood tests to determine the mother's Rh factor and the presence of antibodies that may indicate a risk of the condition.
4. Can Rhesus Disease be prevented?
Rhesus Disease can be prevented by administering Rh immunoglobulin (RhIg) to Rh-negative mothers during pregnancy and after childbirth to prevent the development of antibodies.
5. What are the treatment options for Rhesus Disease?
Treatment for Rhesus Disease may involve close monitoring of the baby's health during pregnancy, blood transfusions for severe cases of anemia, and other interventions to manage complications.
