Once the mother has formed these antibodies, they readily cross the placenta to enter the baby’s circulation and can destroy the baby’s red cells.
If the baby is severely affected, this can lead to death in the womb or soon after birth. Destruction of the red cells can also cause anaemia and jaundice due to an excess of bile pigment from the broken-down cells.
Destruction of the baby’s red cells, with a rapid onset of severe jaundice, is more likely in the first few hours after birth. If the jaundice is severe, it can lead to brain damage.
If Rhesus iso-immunisation occurs and the baby is severely affected, it is possible to treat by the technique of exchange transfusion.
In this, most of the baby’s blood is withdrawn and replaced by Rh negative blood. In this way, the Rh antibodies from the mother which are circulating in the child’s blood are washed out and those which remain are destroyed by the baby’s own immune system. While this is happening, the transfused Rh negative cells do the work of transporting oxygen and are not affected by the antibodies.
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