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Preemie Books
The
Preemie Parents Companion: The Essential Guide to Caring for Your Premature Baby
in the Hospital, at Home, and Through the First Years by Susan L Madden M.S,
William Sears MD, Jane E Stewart MD
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Rh Hemolytic Disease of the Newborn The disease is called Rh hemolytic disease of the newborn. Those whom it kills die before birth or soon thereafter, but there are survivors who recover completely; others are left damaged for life in mind and body. This is a disease in which a pregnant woman's body rejects and may destroy her own unborn child. Every person, both men and women, inherits a blood type that is either "Rh positive" or Rh negative". (The Rh factor is named for its similarity to a substance found in the blood of rhesus monkeys). If a woman is born and grows up with Rh positive blood (85% of our population), or if both she and her husband are Rh negative, there is "no reason for concern". Women with Rh negative blood who may become impregnated with Rh positive sperm or direct transfusion of Rh positive blood should be concerned about the potential of "hemolytic disease" for any future fetus. Approximately eight percent of all pregnancies in the United States are complicated by this incompatibility between the father's blood and the mother's blood. It is known as Rh incompatibility--where the mother has blood which is Rh negative and the fetus inherits the father's Rh positive blood. It was in the early 1930's that this condition was first technically described, and then it took 30 more years for scientists to achieve the breakthrough in management of the problem. In 1968 the first treatment system was licensed by the federal Food and Drug Administration (FDA). Currently, the medical profession offers a treatment system which can greatly reduce the numbers of damaged babies that formerly resulted whenever this incompatible condition occurred. A year ago, in March 1995, a new improved method of treatment was licensed by the FDA which can be administered intravenously. This has simplified the treatment process. Before any treatment system became available, the death rate associated with Rh hemolytic disease was 50 percent. Among those who survived the acute stage, mental retardation, hearing loss, cerebral palsy, and epilepsy were likely to develop. At one time the neurologic syndrome--kernicterus--accounted for 10% of all cases of cerebral palsy. Early treatment attempts involved exchange transfusion--removing the infant's blood and replacing it, or the early induction of labor. These difficult techniques resulted in the deaths of the affected infants being reduced to about 5%, but still many of the survivors were damaged. In order to take advantage of today's technology, parents must be aware of the threat to their baby. Trouble doesn't start until the Rh factor enters the Rh negative mother's circulatory system--during delivery of the infant, during an abortion, during miscarriage, or during bleeding of the fetus at any time during pregnancy, including stillbirth. If the mother's body senses that a "foreign" substance has been introduced during these times, her natural protective immune response is to produce antibodies against it. The antibodies themselves at this time are harmless, but if the woman becomes pregnant a second time with another Rh positive baby the antibodies will then cross the placenta and "attack' the fetal red blood cells, causing anemia of the Rh positive fetus. The
pre-treatment era incidence of Rh disease was 45 impacted infants for every
10,000 total births (live births and still births). By the year 1986, this
incidence had been reduced to 10.6 impacted infants for every 10,000 total
births. At that time, researchers were predicting that the minimum achievable
incidence rates of Rh disease in the United States to be 3.1 per 10,000 total
births. Based on these estimates we still appear to be far from the achievable
minimum. Copyright © 2000 The
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