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![]() It's normally removed from the blood by the liver, so it can be passed out of the body in urine. Bilirubin is a yellow substance that's made naturally in the body when red blood cells are broken down. Jaundice is caused by a build-up of a chemical called bilirubin in the blood. In babies with dark skin, the yellowing will be most obvious in their eyes or on their palms and soles. Jaundice in newborn babies turns their skin and the whites of their eyes yellow. In the newborn baby, this may cause pale skin, increased breathing rate, poor feeding or jaundice. The antibodies attack the baby's RhD positive blood, destroying the red blood cells. This happens when the antibodies from the mother's RhD negative blood cross the placenta into the baby's blood. Haemolytic anaemia occurs when red blood cells are destroyed. Symptoms can sometimes develop up to 3 months afterwards. If a baby has rhesus disease, they won't always have obvious symptoms when they're born. In some cases, the baby may also have low muscle tone (hypotonia) and they may be lacking in energy. The two main problems caused by rhesus disease in a newborn baby are haemolytic anaemia and jaundice. If the anaemia is severe, complications of rhesus disease, such as internal swelling, may be detected during scans. This doesn't usually cause any noticeable symptoms, but it can be detected with an ultrasound scan known as a Doppler ultrasound. If your baby is anaemic, their blood will be thinner and flow at a faster rate. If your baby develops rhesus disease while still in the womb, they may become anaemic (iron defiency anaemia) because their red blood cells are being destroyed faster than usual by the antibodies. Around 50% of babies diagnosed with rhesus disease have mild symptoms that are easily treatable. The symptoms of rhesus disease depend on how severe it is. Rhesus disease only affects the baby, and the mother won't experience any symptoms. However, treatment is usually effective and these problems are uncommon. In other cases, it could lead to brain damage, learning difficulties, hearing loss and blindness and vision loss. If rhesus disease is left untreated, severe cases can lead to stillbirth. Treatment for rhesus disease after delivery can include a light treatment called phototherapy, blood transfusions, and an injection of a solution of antibodies (intravenous immunoglobulin) to prevent red blood cells being destroyed. After delivery, the child is likely to be admitted to a neonatal unit (a hospital unit that specialises in caring for newborn babies). A blood transfusion to the unborn baby may be needed in more severe cases. If an unborn baby does develop rhesus disease, treatment depends on how severe it is. The pregnancy will be monitored more closely than usual, as will the baby after delivery. ![]() ![]() If a woman has developed anti-D antibodies in a previous pregnancy (she's already sensitised) then these immunoglobulin injections don't help. This anti-D immunoglobulin helps to remove the RhD foetal blood cells before they can cause sensitisation. If the mother is RhD negative, she'll be offered injections of anti-D immunoglobulin at certain points in her pregnancy when she may be exposed to the baby's red blood cells. Rhesus disease is uncommon these days because it can usually be prevented using injections of a medication called anti-D immunoglobulin.Īll women are offered blood tests as part of their antenatal screening to determine whether their blood is RhD negative or positive. ![]() The antibodies can continue attacking the baby's red blood cells for a few months after birth. If she's pregnant with an RhD positive baby, the antibodies can cross the placenta, causing rhesus disease in the unborn baby. If sensitisation occurs, the next time the woman is exposed to RhD positive blood, her body produces antibodies immediately. Sensitisation happens when a woman with RhD negative blood is exposed to RhD positive blood, usually during a previous pregnancy with an RhD positive baby. The woman’s body responds to the RhD positive blood by producing antibodies (infection-fighting molecules) that recognise the foreign blood cells and destroy them. The mother must have also been previously sensitised to RhD positive blood. Rhesus disease only happens when the mother has rhesus negative blood (RhD negative) and the baby in her womb has rhesus positive blood (RhD positive). Rhesus disease doesn't harm the mother, but it can cause the baby to become anaemic and develop newborn jaundice. It's also known as haemolytic disease of the foetus and newborn (HDFN). Rhesus disease is a condition where antibodies in a pregnant woman's blood destroy her baby's blood cells.
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