Blood Typing

bravera · Feb 10, 2014

You're right. Being Rh negative means that you lack the D antigen on the surface of your cells, also known as the RH factor. Being pregnant with a baby whose blood type is Rh positive would cause your immune system to essentially view the baby's blood cells as foreign, launching an immune attack via antibodies that are sensitized to destroy the Rh factor. The Rhogam shot is only given to women with a negative blood type for this reason, because being Rh positive would not launch an immune response because the D antigen is there, and therefore an Rh positive baby is not seen as foreign. AB is the universal recipient and therefore would not attack A, B, or O bloodtypes, whereas O can only accept O, so a baby with B or A type blood would be seen as a threat to her immune system, regardless of Rh factor. Hope this helps!

jackiei3 · Feb 10, 2014

Thank you for answering. It looks like I did choose the right answer then! I was just so lost because in class she said only Neg RH would need the shot yet the question was not like that at all. Got to love exams!

cayenne06, MSN, CNM · Feb 10, 2014

Yes, if you quoted the question verbatim, then there are two equally correct answers. Positive mothers never need rhogam, but you are right that babies of positive women do have the potential to have other types of antibody incompatibilities. But you should definitely review this with the professor and find out what he/she was looking for. Rh incompatibility is extremely confusing and it is possible the professor isn't 100% sure of the proper management. Hell, RNs, NPs and MDs who don't work in mat/child health are often confused about this issue! I wouldn't be a bit surprised if an A&P professor didn't have a full understanding.

NurseGirl525, ASN, RN · Feb 11, 2014

If you read the question it's the second baby that died. If it is your first pregnancy and you are exposed it doesn't matter because of it's just the exposure. But now your body will make the antibody and if there is no shot the next baby will die because of it. I hope I am explaining this ok. First pregnancy ok, subsequent ones, bad without the shot.

cayenne06, MSN, CNM · Feb 13, 2014

If you read the question it's the second baby that died. If it is your first pregnancy and you are exposed it doesn't matter because of it's just the exposure. But now your body will make the antibody and if there is no shot the next baby will die because of it. I hope I am explaining this ok. First pregnancy ok, subsequent ones, bad without the shot.

Just nitpicking, but it *is* possible for the first baby to be affected if there are multiple instances of blood mixing without appropriate rhogam prophylaxis; for example, maybe a significant late firstri subchorionic hemorrhage followed by a third tri MVA. These situations are quite rare, but still possible.

NurseGirl525, ASN, RN · Feb 14, 2014

I was trying to explain why the 2nd baby died and the first didn't and why she would need the shot now. Not saying that absolutely every case is that way. Just explaining why a shot would be needed now. Maybe she didn't get one for the first pregnancy.

nurseprnRN, BSN, RN · Feb 14, 2014

Test Question Confusion
Mother had negative RH factor, father has a positive RH factor, their fetus has a positive RH factor. Mother is sensitized and produces RH antibodies. Next pregnancy her baby dies due to these antibodies.
My QUESTION: I took my first A&P II lecture exam today and the question was, "What blood type does a mother need to NOT have to worry about getting a RogHam shot"?
A-
O+
AB-
AB+
I was confused because I thought as long as the mother doesn't have a negative RH factor she wouldn't need the shot. But that was not an option to choose from. I chose AB+ because I figured no matter what blood type the baby was the mother would not produce A, B or RH antibodies. Am I right? If not PLEASE HELP ME I DON'T UNDERSTAND!! I tried researching it but the answers are a little querky.

Now I'm confused, because you are correct-- if the mother is not Rh-, she is Rh+, then she need not worry about making antibodies to an Rh+ fetus. But two of your choices there are Rh+, so I don't know what you meant when you say that was "not an option to chose from."

As to making antibodies to another blood type, that's a different matter, not Rh. And it's RhoGam, (see the Rh in there? H is not capitalized...)

Interestingly, this is probably why women were hanged/burnt/drowned as witches in the years when that was being done. "My first baby was fine, but she was my midwife for all the rest of them, and they all died! It must be her fault!"

KelRN215, BSN, RN · Feb 16, 2014

Test Question Confusion
Mother had negative RH factor, father has a positive RH factor, their fetus has a positive RH factor. Mother is sensitized and produces RH antibodies. Next pregnancy her baby dies due to these antibodies.
My QUESTION: I took my first A&P II lecture exam today and the question was, "What blood type does a mother need to NOT have to worry about getting a RogHam shot"?
A-
O+
AB-
AB+
I was confused because I thought as long as the mother doesn't have a negative RH factor she wouldn't need the shot. But that was not an option to choose from. I chose AB+ because I figured no matter what blood type the baby was the mother would not produce A, B or RH antibodies. Am I right? If not PLEASE HELP ME I DON'T UNDERSTAND!! I tried researching it but the answers are a little querky.

Both the women with O+ and AB+ are fine and will not need Rhogam. There is the possibility for ABO incompatibility with the O+ woman but Rhogam can't do anything for that (people with O blood already have Anti-A and Anti-B antibodies, they don't produce them in response to an exposure and Rhogam only affects anti-Rh antibodies) and Rh+ women never need Rhogam.