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In the case of pregnancy, when an Rh D- mother carries an Rh D fetus, some of the fetal red blood cells may cross the placenta into the maternal circulation, sensitising the mother to produce anti-Rh D antibodies.
Since the mixing of fetal and maternal blood occurs mainly during separation of the placenta during delivery, the first Rh D pregnancy rarely causes any danger to the foetus as delivery occurs before the synthesis of antibodies by the mother.
Normally, no extra medical intervention is required when maternal Rh status is Rh D , nor Rh D- mothers going through first pregnancy.
After birth, the symptoms of the child are similar to that of incompatible blood transfusion in adults. The yellowing of the umbilical cord, skin and eyes, also known as jaundice, may arise within 24 to 36 hours of birth.
Blood plasma can also be used for determining the foetal Rh D status if the mother is Rh D- as maternal blood plasma contains maternal DNA and trace amounts of foetal DNA.
Blood samples can be obtained through venipuncture of the mother.
The two most common invasive methods of extracting foetal DNA are chorionic villus sampling (CVS) and amniocentesis (AMC). Trans-cervical sampling involves inserting a catheter through the cervix into the placenta to obtain villi, ultrasound is used to guide the catheter to the site of sampling.
It will then be removed from the maternal body and the amniotic fluid extracted will be sent to the laboratory for further testing.
By checking the existence of the Rh D gene in the individual’s genome, the presence of rhesus D (Rh D) antigens can be inferred.