There is a wide range of risk factors for a high-risk pregnancy, including diabetes, kidney disease, high blood pressure, epilepsy, thyroid disease, heart disease and blood disorders. One such blood disorder is hemolytic disease of the fetus and newborn (HDFN).
A high-risk pregnancy refers to a pregnancy with increased risks for the mother, the fetus or both. If your pregnancy has been identified as being of high risk, you may be feeling anxious about the months ahead.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell (RBC) disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (RhRh factor A protein or antigen found on red blood cells. When an Rh-negative mother carries an Rh-positive fetus, her immune system may make antibodies that attack the fetus' red blood cells.) factor (Rh-positiveRh-Positive A blood type trait that means your red blood cells have the Rh(D) antigen. or Rh-negativeRh-Negative A blood type trait that means your red blood cells lack the Rh(D) antigen.) during pregnancy. Numerous antibodiesAntibody A protein made by the immune system that recognizes and attacks foreign substances, such as bacteria, or in HDFN, fetal red blood cells carrying incompatible antigens. to RBC antigensAntibody A protein made by the immune system that recognizes and attacks foreign substances, such as bacteria, or in HDFN, fetal red blood cells carrying incompatible antigens. can be linked to HDFN, such as those from the ABO and Rh blood groupBlood group A classification of blood based on inherited markers found on red blood cells. The ABO and Rh blood groups are most common in HDFN. systems.
A pregnancy affected by HDFN can lead to a higher risk for complications for the fetus during pregnancy and birth, with the potential for fetal birth or stillbirth in the most severe cases.
Learn more about HDFN symptoms and risks
Specialist care throughout your pregnancy from a multidisciplinary maternal-fetal team will be key to good outcomes. You will be carefully monitored, with regular blood tests and ultrasounds to keep a close eye on your baby in utero. This will allow for rapid intervention if your baby requires an intrauterine blood transfusion (IUT) or if early delivery is advised.
There are rarely risks for the pregnant mother during an HDFN-affect pregnancy. However, prenatal stress can negatively effect infant health and development, so maintaining the health and well-being of the mother during this stressful time will be of benefit to the baby’s well-being.
How to manage your high-risk pregnancy
Navigating a high risk pregnancy can impact a pregnant mother’s mental health and well-being. By developing the right mindset and finding ways to support your physical, mental and emotional health, the challenges of a high risk pregnancy will become more manageable.
1. Build a strong support network
As well as a trusted medical team, your partner, family and friends will be of valuable support to you during your pregnancy.
2. Maintain your routine
Feeling overwhelmed and anxious might make you feel like hiding out, or maybe spending the day in bed. While rest and relaxation is highly recommended, a routine will give structure to your day. It can give you a sense of maintaining control when feelings of uncertainty and unpredictability surface.
3. Practice self-care
Take care of yourself and you are taking care of your baby. Get plenty of sleep, get some fresh air, practice your deep breathing and meditation techniques for stress management, read, relax and avoid stressful situations where possible.
4. Adopt a healthy diet and lifestyle
A healthy diet will support your growing body and give you the energy to manage your pregnancy. A balanced diet of protein, carbohydrates, healthy fats and plenty of fruit, vegetables and eight to 12 glasses of water daily, is advised for good nutrition. Add to that, vitamin supplements of iron, folic acid and a multivitamin, if recommended by your doctor.
Unless you are on bed rest, light exercise will boost your cardiovascular healthy, and your mental health will benefit too.
5. Stay informed and proactive
Read up on HDFN and possible complications for your baby during pregnancy and birth. Stay informed as your pregnancy progresses and be ready to signal any concerns or ask questions. As your due date approaches, be prepared for your birth and next steps.
