[oramar]

Tell me what kind of problems you have seen when the mother has type O blood and the infant has type A. I know there is jaundice in SOME cases but how bad does it get and does it get worse with subsequent pregnancy? That is providing the subsequent infants are type A.

[kizzykatlove]

it's not so much the blood type .. it's the RH factor in the blood that makes the babes jaundice..

[oramar]

Originally Posted by kizzykatlove

it's not so much the blood type .. it's the RH factor in the blood that makes the babes jaundice..

That is what everybody thinks but there is such a thing as A/O incompatability. There is excellent article in Journal Family Practice, Sept 92. But I wanted to know what nurses experience.

[racing-mom4]

Ok this is a question I had while I was in school and it never could get answered---so you OB nurses may know.

Lets start with I never can remember who gets the Rhogam shot? RH+ moms or - moms. Anyways the question I had was back before Rhogam what did mothers do??? I ask this because during my OB rotation I had a patient who had her 1st baby in a village in Mexico/ the mother never got Rhogam so each additional baby was sick and required extensive Nicu stays and blood transfusions.
Of course my interview with her she said in broken English said she wanted "many more babies"
and it got me to thinking--100 years ago did (the RH+/- cause I dont remember) moms just have babies that they had to watch die??
and what about under developed countries who dont have Rhogam.
And what about the Amish---some moms only go to midwives and may not get Rhogam.

This has always been interesting to me, so if you could enlighten me it would make my day..
Thanks

[oramar]

It is the Rh neg mom that gets the Rhogan and that is when the infant is A/B/O posiitve. I am old enough to remember the pre Rhogan days and RH neg moms with RH pos baby were a major cause of fetal demise and injury. It was very nasty situation. Rhogan came out one year before my son was born, a fact for which I was very grateful because I knew I would have had big problems. Most people are oblivious to those unpleasant facts these days.

[robynv]

i am O+ and my son is A+.
He spent time in the NICU for many things due to his prematurity, but I read his records and one of the things listed was ABO incompatibiltiy. the nurses at the time said pretty much that sometimes these babies(Omom A baby) can get very jaundiced. I know my son spent much time under the bili lights. we called it his tanning booth.

[kizzykatlove]

wow this is interesting .. i don't remember hearing this 22 years ago in nursing school.. keep up the great posts and teach this old dog new tricks...thank you all

[Elvish]

We do see ABO incompatibility but more often than not, a baby with a diff blood type than mom is ok. Most of the time they don't need phototx (at least not in our wellbaby nsy). We watch them all, but we especially watch those with pos Coombs (which they automatically get tested for if mom is Opos, Oneg, or Rh-neg with any blood type). Very fortunately, even most of THOSE turn out to be alright too. At least in my experience anyway.

Then you get those nights where you get 3-4 +Coombs and they all have to be started on lights before 24hours of age.....it comes in spells, like everything else seems to.

To anwswer another posters question - if the subsequent babies of the moms who didn't get Rhogam were also Rh-, then they (babies) would have been fine. But if mom's 1st baby was Rh+, THAT baby may or may not have been affected - sometimes with the first pregnancy sensitization occurs and it's the subsequent pregnancies that are affected. Either way, if a Rh+ baby is born to a Rh- mom that has already been sensitized, things do not bode well. If the rest of her babies are Rh-, then she is very lucky and so are her babies.

Hopefully this makes sense!

[lindarn]

I am O+ and I gave birth 18 years ago to my daughter, who was A+. She was born at 11:55PM and was under the bili light before the night shift went home that morning. She had a positive Coombs test (the test they do on patients who have received mis- matched blood), and spent a week under the bili light. She is fine, but I wasn't expecting this when I was pregnant. And yes, they do call it ABO incompatibility.
Fortunatetely, my second daughter was O+.

Lindarn, RN, BSN, CCRN
Spokane, Washington

[cherokeesummer]

Originally Posted by oramar

Tell me what kind of problems you have seen when the mother has type O blood and the infant has type A. I know there is jaundice in SOME cases but how bad does it get and does it get worse with subsequent pregnancy? That is providing the subsequent infants are type A.

I don't know the specifics but I do know that whenever we have a mom with O pos, O neg, and any kind of neg we send baby cord blood to the lab for coombs and rh testing.