Rhesus Factor and Incompatibility : What You Need To Know

Rhesus factor also known as Rh factor is described as an antigen that is present on the surface of red blood cells in most individuals. Individual who possess the Rh positive blood type e.g A positive, O positive, AB positive, are said to be rhesus positive while those with negative symbol are said to be rhesus negative.

Rhesus factor is inherited from parents, usually the father.


If you are rhesus positive (RhD positive), this implies that the protein (D antigen) is present on the surface of your red blood cells, however, if you lack the D antigen, you will be rhesus negative (RhD negative).


Over 75% of humans are rhesus positive.


Having Rh negative blood type does not make you unhealthy, apparently, it doesn't affect your health.


Rhesus status only become an issue of concern when a woman whose rhesus status is negative get pregnant and the baby she's carrying is rhesus positive, this is known as Rhesus Incompatibility. Commonly, a child inherits the father's rhesus status.


When some of your baby's blood get in to your bloodstream, your immune system may react to the D antigen in your baby's blood. Your system will see this as a "threat" and your body will create antibodies against it. When this happens, you become Rh sensitized.


If you are carrying your first pregnancy ever, Rh sensitization is not usually an issue. However, this may become a problem when future pregnancy occur with another Rh positive baby.

The antibodies generated by your body during the former pregnancy can easily increase, cross the placenta and attack the baby's blood cells. A previous termination, ectopic pregnancy or miscarriage might have caused a sensitising event without noticing.


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To prevent senzitization - if you are Rh negative, you might need to have an antibody screen (a blood test) during your first trimester, during week 28 of pregnancy and at delivery. The antibody screen is used to discover antibodies, hence, you would be required to take  immunoglobulin. Immunoglobulin is also needed after termination, miscarriage and ectopic pregnancy.

Anti-D injection is made up of antibodies called immunoglobulin, that help protect the fetus from its mother's antibodies. It prevents the Rh-negative mother from producing antibodies during her pregnancy. It does not cross the placenta and it's not harmful.


If you fail to get the Anti-D treatment, Rh sensitization may occur ; The immune response in your second pregnancy will become stronger than the previous pregnancy and this can result to rhesus disease in your baby. The antibodies will begin to attack your baby's blood cells.

This will lead to anaemia , if the anaemia is serious, it can result to life-threatening issues for the baby, which may include, heart failure, inflammation and fluid retention.

After the baby delivery, the liver of the baby won't be capable of coping with the amount of blood cells that require breaking down. The baby could experience Jaundice, which is known as hemolytic disease of the fetus and newborn (HDFN) or hemolytic disease of the newborn (HDN).

If this happens, in severe cases the fetus might not be able to survive it. Many fetuses have died in the past due to this.

Although, nowadays, you don't need to panic if you are already sensitized as treatments are now available to rescue the life of the babies in this condition. This treatment include - transfusing Rhesus negative blood, which is better and more reliable if done before birth, you will only need a "perinatologist" (specialist that take care of pregnant women in special conditions) for proper monitoring. But you would like to agree with me that prevention is definitely the best option

This is why routine Anti-D injection is important as part of the antenatal service.



After baby delivery, a sample of the baby's blood would be taken from the umbilical cord and tested, so as to know his/her blood type and rhesus status. If the baby happens to be rhesus positive, there would be a need for you to take another injection of Anti-D, which must be given within 72 hours of child delivery.

Related : Genotype : types and compatibility


You would also be tested for antibodies, you may be required to take a larger dose of Anti-D if much quantity of fetal blood is present in your body.


Anti-D however, may not be required, if your baby is having the same rhesus status as you i.e rhesus negative.

It should be noted that -  Anti-D injection only work for short time, therefore, you will need to repeat this treatment each time you get pregnant.

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With good antenatal care, Rhesus Incompatibility can't get complicated.

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