Prenatal
Care
Rh Incompatibility
Blood type is identified by two major components a letter (A, B, AB, or
O) and the Rh factor. If your blood contains the Rh factor, you are Rh
positive, if it lacks this factor, you are Rh negative. Therefore, if your
blood type is AB and your are Rh-negative, you are said to have AB-negative
blood.
If an Rh-negative person
receives Rh Positive, she
will become sensitized and her body will produce antibodies to attack the
foreign red blood cells. This is significant in pregnancy for an
Rh negative woman because if her note is Rh positive, the child can be
Rh positive. During amniocentesis or the delivery of the
placenta, it is possible for the baby's blood to come in contact with
the mother's blood. If this happens, the mother's body will produce
antibodies against the Rh-positive cells. These antibodies will attack the
Rh- positive blood cells and cause them to die. This disease is called
hemolytic disease of the new born. Since the sensitization does not
occur until after the birth, the first baby is not affected, unless the
woman was previously sensitized and not treated. If a woman is not
treated and becomes pregnant again with an Rh positive baby, the antibodies
will cross the placentra and will kill the fetus's red blood
cells.
To prevent hemolytic disease of the newborn, RhoGAM, an Rh-immune
globulin, is administered, after the birth of an Rh-positive infant,
as well as after a miscarriage, an abortion, or amniocentesis. It is also
given at 28 weeks of pregnancy. RhoGAM acts by suppressing the specific
immune response of Rh-negative individuals to Rh-positive red blood
cells. Since the woman does not produce antibodies, subsequent
pregnancies will not be affected, and the woman can give birth to healthy
newborns in the future. Hemolytic disease of the newborn is rare since
the development of RhoGAM.
Group B Strep
Group B streptococcal (GBS) infection is found in the genital area
of up to 30 percent of healthy women. Most infected pregnant women show no
signs of illness, but are at increased risk for kidney
infections premature rapture of the membrane, prater labor, and
stillbirth. The biggest danger is to infants who become infected during
birth while not all infants become ill. Infants who do
contract the infection can suffer serious complications. The factors
that increase the risk if complications are premature, fever during
labor, high levels of bacteria, and prolonged rupture of the membranes prior
to delivery.
According to the Centers for Disease
Control (CDC), a culture of the
vaginal and rectal area to check for group B strep Should be performed
on all pregnant women at 35 to 37 weeks of pregnancy. Some
facilities also perform a culture upon admission in labor. Women who tested
positive during pregnancy with either the genital culture , who previously
had an infant with GBS, or who deliver before 37 weeks gestation should be
treated during labor with antibiotics. Women who did not have a culture
done or whose culture result is not known should be given antibiotics
if they are less than 37 weeks pregnant, have a temperature of over 100.40
F (Fahrenheit). Treatment with antibiotics during labor has been shown to be
highly effective in preventing complications in newborns if the antibiotics
are administered 4 or more hours prior to delivery. If the infant is delivered less than 4 hours following the administration of antibiotics
or shows signs or infection, a partial or full septic workup may
be required. This may include blood tests, a spinal tap chest X-rays,
and /or intravenous administration of antibiotics. The CDC also recommends
that all infant of treated mothers be observed for 48 hours after
delivery.
