Rh Sensitization During Pregnancy: Treatment Overview

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Treatment Overview

If you are sensitized to the Rh factor

If your blood is Rh-negative and you have been sensitized to Rh-positive blood, you now have antibodies to Rh-positive blood. The antibodies kill Rh-positive red blood cells. If you become pregnant with an Rh-positive baby (fetus), the antibodies can destroy your fetus's red blood cells. This can cause anemia.

If you are already Rh-sensitized and are pregnant, your treatment will focus on preventing or minimizing fetal harm and on avoiding early (preterm) delivery.

Treatment options depend on how well or poorly the fetus is doing.

• If possible, the father will be tested to see if the fetus could be Rh-positive. If the father is Rh-negative, the fetus is Rh-negative and is not in danger. If the father is Rh-positive, amniocentesis will probably be used to learn the fetus's blood type. In some medical centers, the mother's blood can be tested to learn her fetus's blood type. This is a new test that is not widely available.
• If testing shows that your fetus Rh-positive but is only mildly affected by your Rh factor antibodies, you will be closely monitored until your pregnancy reaches term. Your fetus will be delivered early only if his or her condition worsens.
• If testing shows that your fetus is moderately affected by your Rh antibodies, your fetus's condition will be closely monitored until his or her lungs are mature enough for a preterm delivery. A cesarean section may be used to deliver the baby quickly or to avoid the difficulty of inducing labor before term. A moderately affected newborn sometimes requires a blood transfusion immediately after birth.
• If testing shows that your fetus is severely affected by your Rh factor antibodies, a blood transfusion may be given before birth (intrauterine fetal blood transfusion). This can be done through the fetus's abdomen or directly into the fetus's umbilical cord. A preterm delivery is likely to be needed. Multiple blood transfusions are sometimes necessary to keep a fetus healthy until the fetal lungs mature enough to function after birth. Often a cesarean section is done to deliver the baby quickly. A blood transfusion is sometimes necessary immediately after birth.

Last updated:	November 02, 2007
Author:	Kathe Gallagher, MSW
Reviewed By:	Joy Melnikow, MD, MPH - Family Medicine, Gregory A L Davies, MD, FRCSC, FACOG - Maternal-Fetal Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer