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Blood group check during pregnancy

  1. During the twelfth week of your pregnancy your blood group of the A-B-O system and the Rhesus factor D and C will be determined. Antibodies against rarer blood groups are also looked at: these are the irregular antibodies. How exactly does that work?

  1. Your red blood cells contain proteins. These are not the same for everyone. Which proteins you have on your red blood cells determines which blood group you have. For example, if you have protein A on your red blood cells, you have blood group A. In addition, your red blood cells also determine the so-called rhesus factor, another characteristic of your blood. There are hundreds of blood groups. In practice, we are mainly talking about the blood groups A, B, AB, O and the Rhesus D (RhD) trait. The combination of these two systems yields 8 blood groups: A +, A-, B +, B-, AB +, AB-, O + and O-.

Antibodies

  1. There are also antibodies in the blood. These antibodies are directed against the blood groups. When a person with blood group A ingests antibodies A, they form a connection with the cell wall. The antibodies then destroy the entire red cell. Someone with blood group O has antibodies for blood groups A and B. Someone with blood group AB has no antibodies (otherwise his own red blood cells would attack and break down each other). Doctors must take this into account with blood transfusions. If you are pregnant, it is important to know if you are Rh negative, because that can have consequences for your baby.

Rhesus system

  1. About 84 percent of people have the Rhesus factor, which we call Rhesus (D) positive. The rest is rhesus (D) negative. You can be rhesus (D) negative yourself, but you can be pregnant with a rhesus (D) positive baby. During your pregnancy and especially at birth, your baby's blood cells enter your bloodstream. If you are negative for the Rhesus factor, your immune system recognizes the foreign positive blood cells and you start to produce antibodies. You don't notice it yourself. Your first child usually does not suffer from it either. You now have antibodies against the positive factor in your blood and these can reach the baby via the placenta in the next pregnancy. If your baby is Rhesus positive, his red blood cells are attacked and partly broken down by those antibodies. This ensures that your baby looks yellowish after birth (Rhesus disease). To prevent this, your baby's Rhesus blood group will be tested on the 27th week. If you are expecting a Rhesus (D) positive child, you will be given anti-D in the 30th week.

ADCC test

  1. If antibody formation has nevertheless taken place, the doctor can see with an ADCC test whether there is a high chance of breakdown of red blood cells in the baby. This test is expressed as a percentage and is repeated several times during pregnancy. If the test result is 10 percent, the baby is not expected to break down many blood cells. The baby will not turn very yellow.

After birth After the birth, the doctor checks the baby's blood type. If that blood group is negative, nothing will happen. If the baby is positive for the Rhesus factor, then his mother will be given anti-D again. This prevents the positive red D cells from the baby from triggering her immune system to make antibodies. This article has been approved by Dr. J.M. de Bont, pediatrician-pediatric neurologist at UMC Utrecht. Last revised Aug 31, 2018 Also read Blood, precious red fluid Blood and Platelet Transfusion Don't miss anything?

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