Rh incompatibility in pregnancy nursing NCLEX maternity review: management, pathophysiology, Rhogam shot, and hemolytic disease of the newborn.
What is Rh incompatibility? It occurs when a father who is Rh-positive and a mother who is Rh-negative have a baby that is Rh-positive. The baby’s Rh-positive blood will leak into mom’s circulation (most likely during delivery), and this will cause the mother’s to build antibodies.
The baby of the first pregnancy is not typically harmed. However, the baby during the second pregnancy, who is Rh-positive, will be affected because those antibodies created during the first pregnancy are in mom’s circulation. These antibodies will attack the baby’s red blood cells.
This will lead to hemolytic disease of the newborn and cause: anemia, jaundice, heart failure, swelling/edema, splenomegaly along with hepatomegaly.
The key is to keep mom from being sensitized, which is done through giving her a medication called Rhogam. This medication is given at 28 weeks and again at 72 hours after delivery if the baby is Rh-positive.
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