Bridget was born on May 5, 2005. Soon after her birth, her doctor diagnosed her with Rh incompatibility disease. This took everybody by surprise as Kim, her mother, had given birth to two babies previously with no problems. She had received Rh immune globulin shots for those births and also had the shot for her pregnancy with Bridget.
It is not uncommon for newborn babies to have jaundice, which is a yellow discoloration of the skin and the whites of the eyes. It is caused by a build-up of a yellow pigment in the blood called bilirubin. In most cases, jaundice goes away without treatment, but in severe cases, it can pose a risk of brain damage. Bridget showed signs of jaundice, and her bilirubin numbers were somewhat elevated, so she received treatment before going home.
Not long after Kim and her husband, Edward, had taken Bridget home they noticed she was looking dramatically yellow. After lab tests showed that her bilirubin level was dangerously high, she was rushed back to the hospital. Her doctor, Igor Gladstone MD, considered giving her a full blood exchange, but instead decided to give her a transfusion of red blood cells. She ended up having two transfusions. These transfusions, along with other therapies for jaundice, showed immediate results, and Bridget’s numbers dropped to a far safer level. Five days after receiving her life-saving transfusion, Bridget went home again, this time for good. She is now a happy, healthy little girl.
Hemolytic Disease of the Newborn
Hemolytic disease of the newborn is caused by the incompatibility between the blood of the mother and her baby. In the case of the Rh blood group system, most people have Rh-positive blood, meaning that they produce the Rh factor, an inherited protein found on the surface of their blood cells. The others lack this Rh factor and are considered Rh-negative.
An Rh-negative mother and an Rh-positive father may conceive a baby who inherits the father’s Rh-positive blood type. There is then a danger that, during pregnancy and especially during labor and delivery, some of the fetus’s Rh-positive red blood cells may get into the mother’s bloodstream. Since red blood cells containing the Rh factor are foreign to the mother’s system, her body tries to fight them off by producing antibodies against them. This triggering of the mother’s immune response is referred to as “sensitization.”
In a first pregnancy, there is very little danger to an Rh-positive fetus because the baby usually is born before the mother is sensitized, or at least before the mother produces substantial Rh antibodies. But, if sensitization occurs, the woman will continue to produce antibodies which may be present in her blood throughout her life. In each later pregnancy, maternal Rh antibodies can cross the placenta and reach the fetus. Each subsequent baby becomes at greater risk for more severe Rh disease. If the fetus is Rh-positive, the mother’s antibodies will destroy fetal blood cells, resulting in Rh disease for the baby.
To prevent Rh disease, all Rh-negative mothers should receive an injection of Rh immune globulin, which protects the fetus from antibodies from its mother. This treatment works in the vast majority of cases, but a few women cannot benefit from it.