Rhesus (Rh) factor is an inherited protein found on the surface of red blood cells. If your blood has the protein, you're Rh positive. If your blood lacks the protein, you're Rh negative.
Rh positive is the most common blood type. Having an Rh negative blood type is not an illness and usually does not affect your health. However, it can affect your pregnancy. Your pregnancy needs special care if you're Rh negative and your baby's father is Rh positive.
Your health care provider will recommend an Rh factor test during your first prenatal visit. This test will identify your blood type and whether your blood cells carry the Rh factor protein.
The Rh factor test is done during pregnancy to identify a woman's Rh factor. In some cases, the baby's father might need an Rh factor test, too.
During pregnancy, problems can occur if you're Rh negative and the baby you're carrying is Rh positive. Usually, your blood does not mix with your baby's blood during pregnancy. However, during delivery or certain times during pregnancy, a small amount of your baby's blood could come in contact with your blood.
If you're Rh positive, Rh incompatibility isn't a concern. If you're Rh negative and your baby is Rh positive, however, your body might produce proteins called Rh antibodies after exposure to the baby's red blood cells. The antibodies produced aren't a problem during the first pregnancy. The concern is with your next pregnancy. If your next baby is Rh positive again, your body will produce Rh antibodies that can cross the placenta and damage the baby's red blood cells. This could lead to life-threatening anemia, a condition in which there are not enough red blood cells. If this condition is not prevented, each Rh positive baby you carry after your first pregnancy might have severe anemia.
If you're Rh negative, you might need to have another blood test — an antibody screen — during your first trimester and again during week 28 of pregnancy. The antibody screen is used to detect antibodies to Rh positive blood.
If you haven't started to produce Rh antibodies, you'll need an injection of a blood product called Rh immune globulin. The immune globulin prevents your body from producing Rh antibodies during your pregnancy.
If your baby is born Rh negative, no additional treatment is needed. If your baby is born Rh positive, you'll need another injection shortly after delivery.
If you're Rh negative and your baby might be or is Rh positive, you'll also need an Rh immune globulin injection after any situation in which your blood could come into contact with the baby's blood, including:
- Ectopic pregnancy — when a fertilized eggs implants somewhere outside the uterus, usually in a fallopian tube
- Molar pregnancy — a noncancerous (benign) tumor that develops in the uterus
- Amniocentesis — a prenatal test in which a sample of the fluid that surrounds and protects a baby in the uterus (amniotic fluid) is removed for testing or treatment
- Chorionic villus sampling — a prenatal test in which a sample of the wispy projections that make up most of the placenta (chorionic villi) is removed for testing
- Bleeding during pregnancy
- Blunt trauma to the abdomen during pregnancy
- Rotation of a baby in a breech position — such as buttocks first — before labor
- Fetal blood sampling
If the antibody screen shows that you're already producing antibodies, an injection of Rh immune globulin won't help. Your baby will be carefully monitored. If necessary, he or she might be given a blood transfusion through the umbilical cord during pregnancy or immediately after delivery.
|Mother's Rh factor
||Father's Rh factor
||Baby's Rh factor
||Could be Rh positive or Rh negative
||Could be Rh positive or Rh negative
||Rh immune globulin injections
An Rh factor test is a basic blood test. The blood sample is usually taken during the first prenatal visit and sent to a lab for analysis. No special preparation is necessary.
If you're Rh positive, no action is needed.
If you're Rh negative and the baby's father is Rh positive, there's a potential for your body to produce antibodies that could harm your baby. If you have vaginal bleeding at any time during pregnancy, contact your health care provider immediately. Also, talk with your health care provider about scheduling an Rh immune globulin injection during your pregnancy and make sure you remind your health care team of your Rh status during labor.
June 23, 2015
- Moise KJ. Management of pregnancy complicated by Rhesus (Rh) alloimmunization. http://www.uptodate.com/home. Accessed June 3, 2015.
- Moise KJ. Overview of Rhesus (Rh) alloimmunization in pregnancy. http://www.uptodate.com/home. Accessed June 3, 2015.
- Moise KJ. Prevention of Rh (D) alloimmunization. http://www.uptodate.com/home. Accessed June 3, 2015.
- Frequently asked questions. Pregnancy FAQ027. The Rh factor: How it can affect your pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/The-Rh-Factor-How-It-Can-Affect-Your-Pregnancy. Accessed June 3, 2015.