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Rhesus disease is a condition where a mother’s immune system attacks her unborn baby’s red blood cells, causing anemia and jaundice. It can be prevented with an injection of anti-D immunoglobulin, given to rhesus-negative pregnant women before their immune system develops antibodies.
Rhesus disease is a condition that affects an unborn baby when its mother’s immune system generates antibodies that attack the baby’s red blood cells. Pregnant women do not show any symptoms, but babies born with this disease often have anemia and jaundice. Rhesus disease was once very common in women with certain blood types, but is now relatively rare, as it can be prevented with a simple injection. This condition is also called Rh(D) disease, or hemolytic disease of the newborn.
The term Rh(D) refers to a protein called rhesus factor D. This protein is found on the surface of red blood cells in people who are said to be rhesus-positive. Not all people are rhesus-positive; those that lack rhesus factor D protein are called rhesus-negative.
For Rh(D) disease to develop in an unborn baby, two conditions must be met. First, there is a risk of developing rhesus disease when a woman with a rhesus-negative blood type is pregnant with a child who has rhesus-positive blood. For the disease to actually develop, however, the pregnant woman must have previously been exposed to rhesus-positive blood. This second condition must be met for the woman’s immune system to generate antibodies against the baby’s rhesus-positive blood cells.
A typical scenario in which rhesus disease develops is when a pregnant woman with a rhesus-negative blood group has previously given birth to a child with a rhesus-positive blood group. In this situation, her immune system was exposed to Rhesus factor D during her first pregnancy. This initial exposure is called sensitization. In her second pregnancy, if this baby is also Rhesus positive, the woman’s immune system will generate antibodies that attack the baby’s red blood cells. These antibodies can cross the placental barrier from mother to child and destroy fetal red blood cells.
Until the late 1970s, Rhesus disease was a relatively common neonatal complication. In 1977, a preventive injection was introduced that prevents the immune system from developing antibodies against Rhesus factor D. The injection contains antibodies that recognize Rhesus factor D and destroy red blood cells that are rhesus-positive. This is called anti-D immunoglobulin and is given to all rhesus-negative pregnant women.
This treatment works because it is given to a woman before her immune system develops rhesus factor D antibodies, at around 28 weeks of pregnancy. A Rhesus-negative woman receives this injection every time she is pregnant, ensuring that her immune system never becomes sensitized to producing destructive antibodies.
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