What is Blood Incompatibility? How is the Blood Incompatibility Test Done?

When people with one blood type receive blood from someone with a different blood type, the immune system reacts. This is called ABO incompatibility. ABO incompatibility can also occur between mother and baby.

What is Blood Incompatibility? What Causes Blood Incompatibility?

When the mother is Rh negative and the baby is Rh positive during pregnancy, there is Rh incompatibility between the mother and the baby. During pregnancy, the unborn baby's red blood cells can cross the placenta into the mother's blood. In pregnancies in marriages with blood incompatibility, some additional examinations and approaches should be made in the mother and baby.

• If the mother is Rh-negative, the immune system acts as a foreign substance on the Rh-positive fetal cells. The mother's body makes antibodies against fetal blood cells. These antibodies pass from the placenta to the developing baby and destroy the baby's circulating red blood cells.
• When the red blood cells are broken down, bilirubin is released. When bilirubin rises in the blood, the skin and eyes turn yellow. In Rh incompatibility, the level of bilirubin can be mild or may rise dangerously.
• First-born babies are generally not affected by Rh incompatibility unless the mother has had past miscarriages or abortions. However, antibodies develop in the mother over time and if there is a Rh positive baby in the second pregnancy of the Rh negative mother, the blood incompatibility affects the newborn. This problem is less common in places that provide good prenatal care. This is because special immune globulins called AntiD antibodies (commonly called blood incompatibility needles) are routinely used.
• Hemolytic disease (breakdown of blood) due to Rh incompatibility develops in newborn babies in pregnancies that are not followed closely. Bilirubin is released when the blood is broken down.
• Jaundice usually starts in the first 24 hours in these babies and the jaundice increases very quickly.
• Weakness, difficulty in sucking and muscle weakness may develop in the baby with jaundice.

How to Diagnose Blood Incompatibility?

•  The blood group of the mother and father is determined at the first visit to the doctor during pregnancy.
• Previously abortion, abortion and or stillbirth history is questioned.
• If the Rh factors of the mother and father are negative, there is no problem.
• If the mother is negative and the father is positive, there is a risk of Rh incompatibility if the baby is positive.
• In this case, the mother and father are positive. An indirect Coombs test is requested.
• This test should normally be negative. If it is positive, it means there is Rh incompatibility between the couples.
• The test result also shows the severity of the blood incompatibility.
• The mother is given RhoGam before birth.
• The baby is followed closely for jaundice from the moment of birth.

How to Treat Blood Incompatibility?

Bilirubin is measured from the baby's blood at regular intervals after birth. Bilirubin values ​​were tabulated according to the baby's day, weight and gestational week. Physicians determine the treatment plan to be applied to the baby using this table.
The effects of blood incompatibility on the baby and treatment methods:

• The vascular access of the baby who develops jaundice is opened, fluid is given and phototherapy is started. In phototherapy, UV rays of a certain wavelength are used to dissolve bilirubin, which the newborn's liver does not wash, dissolve in water and excreted from the body in urine. The newborn is placed under fluorescent lamps that give off UV rays (blue light) at regular intervals, and it is expected that jaundice (the bilirubin levels that the liver cannot wash) will decrease by giving enough fluid.
• Direct Coombs test and complete blood count are performed to measure the degree of Rh incompatibility.
• Hemolytic disease has started in babies with positive direct cooms test. As a result, hemoglobin decreases.
• In case of jaundice that cannot be controlled by phototherapy, the baby's blood can be changed.
• In some severe cases, it may be necessary to change the baby's blood several times.
• If the signs of Rh incompatibility started in the womb, the baby's blood can be changed. Blood transfusion can be done during pregnancy.

If Rh incompatibility is not detected early and the baby is not intervened in time, a disease called Kernicterus develops in the baby.

• This disease occurs as a result of the bilirubin substance damaging the brain cells.
• The risk of developing mental and physical disabilities in the baby increases.
• This neonatal There is a risk of continual seizures.
• Severe anemia and related heart failure may develop.
• Kernicterus is a life-threatening condition, but nowadays, close and regular pregnancy follow-up and advanced pre-pregnancy and It is very rare thanks to post-pregnancy care facilities.

What is ABO Incompatibility?

ABO blood group consists of A, B, AB and 0 blood groups.

• A person with blood group A has antibodies against group B and group AB in their blood. A person with B blood group has antibodies against group A and AB group. does not react. Therefore, they are considered “general recipients”.
• There is no reaction if blood type 0 is given to people with blood group A, B or ABO. For this reason, group 0 is called "general donor". However, O group people can only receive O group blood.

Before transfusion of blood and plasma, the blood of the donor and recipient is compared. If there is no reaction as a result of the test, blood can be used. If incompatible blood is given by mistake, the following symptoms occur:

• Low pain,
• Blood in the urine,
• Chilly,
• Fever,
• Nausea and vomiting,
• Shortness of breath,
• Increased heart rate,
• Pain at the infusion site,
• Chest pain,
• Dizziness,
• Bronchospasm (spasm of the muscles lining the lung; causes coughing),
• Jaundice,
• Acute renal failure,
• Low blood pressure,
• Disseminated intravascular coagulation (DIC).

Blood transfusion is stopped as soon as the reaction starts and the patient is treated appropriately.

What Happens in ABO Blood Incompatibility Between Mother and Baby?

• ABO blood incompatibility occurs if the mother has O blood group and the baby has A or B blood group.
• ABO blood incompatibility also causes hemolytic disease in the baby.
• The hemolytic disease seen in ABO incompatibility is not as severe as in Rh incompatibility. However, different levels of jaundice and anemia may develop in the baby.

In ABO incompatibility, the baby's blood passes to the mother during pregnancy and the mother makes antibodies against these blood cells.

• Mother during pregnancy ABO blood group of the baby can be estimated by looking at the blood group and the father.
• If the mother is 0 and the father is group A or B, if the baby is born with the father's blood group, blood incompatibility will develop.

In ABO incompatibility, there is no way to take precautionary measures as in Rh incompatibility. However, babies with known incompatibility are followed up closely for jaundice after birth. Phototherapy and exchange transfusion can be applied according to the level of jaundice. Babies with ABO blood incompatibility rarely need exchange transfusions. Jaundice in these babies can last a long time. As a result, anemia may develop in the early period.

You can ask the expert team of Group Florence Nightingale Hospitals about the issues you are wondering about blood incompatibility and ask for suggestions regarding your question. You can use the contact form on our website to reach us.

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