A fetal loss of any kind, whether it be an abortion or a miscarriage, may unexpectedly affect future pregnancies. One of these ways is by causing a disorder known as hemolytic disease of the fetus and newborn (HDFN).
Let’s explore how the two can be related.
A ‘sensitizing’ event
HDFN is a disease in which a pregnant woman produces antibodies that attack the red blood cells of her fetus, leading to their destruction. This can result in complications such as anemia. In newborns affected by this condition before birth, common complications include the yellowing of the skin due to the buildup of red blood cell byproducts, which will require a period of treatment before it goes away.
During a pregnancy loss, there is the possibility of fetal blood cells coming into contact with the mother’s blood. If there is incompatibility between their blood groups, a “sensitizing” event may occur. Let’s explore what this means.
Read more about HDFN testing and diagnosis
If the mother’s blood group is Rhesus-negative and the fetus’ blood group is Rhesus-positive, the two blood groups are said to be Rhesus incompatible. This can provoke the mother to produce what are known as anti-D antibodies, which remain permanently in her blood.
If the mother becomes pregnant again at a later date and the fetus is again Rhesus-positive, the mother already has anti-D antibodies in her blood due to the earlier sensitizing event. As such, these antibodies will attack the red blood cells of the fetus, resulting in HDFN.
Focusing on prevention
Because of the risk of this happening, Rhesus-negative women who suffer a pregnancy loss for any reason are often given Rhesus immunoglobulin. This treatment works by destroying the fetal red blood cells so that the mother’s immune system is not activated to produce anti-D antibodies.
If you’re currently pregnant and previously experienced a fetal loss and are unsure about whether you were tested for your blood group or whether you received the appropriate care, speak to your OB-GYN. Your doctor will be able to perform another test to assess your current risk of HDFN and take action accordingly.
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