Question

If the husband is Rh(+) and the wife is Rh(-)then
A. No problem with 1st child
B. The second child will have anemia ( Erythroblastosis fetal )
C. The second child will be normal
D. Both ( a ) and ( b )

Answer 1

Hint: When an Rh-negative mother is impregnated by an Rh-positive father, there are chances that the mother will carry an Rh-positive baby.

Complete answer:In that case, the fetus Rh antigens will be perceived as foreign invaders by the mother's body. This can initiate protective mechanisms in the mother's blood that can end up harming the child.
1. During the first pregnancy, the antibodies are produced in lower concentrations and do not harm the fetus. But antibodies against the Rh factor will be produced in the mother’s body during delivery of the first child as there is fluid contact during parturition.
2. During the second pregnancy with a Rh+ baby, the concentration of antibodies against the Rh factor will build up. This will attack the blood cells of the fetus and will cause its death
3. Rh antibodies are small and they can traverse the placenta. They are of IgG type.
Hence, the second baby’s blood cells that have the Rh antigen on them are attacked by the antibodies that reach the fetus through the placenta and umbilical cord.
4. The antibody-antigen complex will result in the lysis of fetal red blood cells (RBCs).
This is known as hemolysis. The heme from the blood cells accumulates and is converted to bilirubin and biliverdin by the liven.
5. These bile pigments accumulate in several parts of the body including the conjunctiva of the eye and soft palate leading to yellowish discoloration of them. This is known as icterus jaundice.
6. The baby will be severely anemic with severe cyanosis, it will eventually die if the hypoxic conditions are prolonged. This is known as erythroblastosis fetalis.

Correct Answer: Option B: The couple’s first child may be born but they are not likely to have their second child without medical intervention

Note: This condition if less severe, can be treated by phototherapy and intrauterine blood transfusion. This is also known as the hemolytic disease of the newborn.