If you are reading this, then I am pretty sure you must have bled at least once in your lifetime, maybe you must have accidentally had a prick and there was a blood flow and you had to stop it. So it would not be news to say that blood flows through every human being that is alive!

IMPORTANT FACTS ABOUT BLOOD GROUP

You may also have taken your biology classes serious to have an idea about the different blood groups in the body, but for the few who weren’t fortunate to be science inclined, I would try to carry you along so that you get the important message I am about to pass.

For simplicity sake, we have come to agree that there are four different types of blood groups, A, B, AB, O, so you can call it ABO system if you wish. These blood groups (A, B) were discovered by some scientist (Von Descastello and sturli) early in the twentieth century (about 1902 precisely) and this was the only classification known at that time, until later in 1940 when Landsteiner and Weiner (another group of scientist made another mind-blowing discovery! They discovered the Rhesus system which was responsible for a certain type of disease in newborn- hemolytic disease of the new-born. Haemolysis simply means the breakdown of blood cells, meaning that at that time, there were some new-borns that died as a result of the rhesus system incompatibility of blood!

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The Rhesus system is just like the ABO blood group, but in this case, it is usually represented by the Rh. Landsteiner and Weiner also discovered another twist, they found out that there were actually two different types of people with the rhesus factor, those who were Rhesus Positive, and those who were Rhesus Negative ( Rh +ve and Rh –Ve).

The negative rhesus was found to be found in some peculiar geography of the world, for example, 95 % of the Basque tribe of Spain have the negative Rhesus factor in their blood. This is high in comparison to the 15% found in Caucasians or the less than 5% in blacks, Asians etc. What this means is that about 95% of the black population has a positive Rhesus factor.

Now that you have understood a little about the rhesus system and its geographical distributions, I would try to remind you of what you must have learned.
I am sure you must have heard that Blood group O is the ‘universal donor of blood’, guess what? When the positives and negatives come into play, O+ve does not qualify into that class of universal donor again! O+ve can only donate to all the other blood groups with a positive rhesus factor, while O –ve can only donate to all blood groups with a negative rhesus factor!

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The reason for this is simple there are substances in the blood called antigen, These antigens are guarded by a specific guardian angel. if a foreign body (antigen ) of A tries to enter the blood group B for instance, the guardian angel called antibody A would prevent the antigen from entering it. This would lead to a mini-war with casualties!

This is probably what happened in the hemolytic disease of the newborn I mentioned earlier

Was that too tough for you to comprehend?

Ok, let me put it in a diagram below to aid your understanding.

BLOOD GP	CAN DONATE TO	CAN RECEIVE FROM
A POSITIVE	A POSITIVE	A POSITIVE, O POSITIVE.
A NEGATIVE	A NEGATIVE	A NEGATIVE, O NEGATIVE.
B POSITIVE	B POSITIVE	B POSITIVE, O POSITIVE.
B NEGATIVE	B NEGATIVE	B NEGATIVE, O NEGATIVE.
AB POSITIVE	AB POSITIVE	A POSITIVE, B POSITIVE, O POSITIVE, AB POSITIVE
AB NEGATIVE	AB NEGATIVE	A NEGATIVE, B NEGATIVE, O NEGATIVE, AB NEGATIVE.
O POSITIVE	A POSITIVE,B POSITIVE, O POSITIVE, AB POSITIVE	O POSITIVE.
O NEGATIVE	A NEGATIVE, B NEGATIVE, O NEGATIVE, AB NEGATIVE	O NEGATIVE

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You must be thinking this is very simple, I am going to go a little deep, so I advise you take extra breaths and read carefully because in a short while you would be learning all about rhesus iso-immunization in the simplest of terms.

There is also a high prevalence of abortion in the world, statistic are not really accurate, WHO alleged approximately 25 million legal and 20 million illegal abortions worldwide as at 1995., In Nigeria, Guttmacher Institute estimated 456,00 of unsafe abortions being done illegally.

Now, what if one of these women happened to be rhesus negative and was impregnated by a rhesus positive man, this would create problems definitely when this abortion is done illegally by a quack.

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Women attend antenatal care to ensure that their pregnancy is well monitored and they would not have a complicated delivery. During the antenatal care, a series of laboratory test is ordered to be done, one of them is blood group, I am sure you already know the answer because you have been following my small story.

During pregnancy, there are many situations that lead to blood spill before the baby is finally born e.g. A miscarriage, bleeding from a pregnant woman before the onset of labor (antepartum hemorrhage) or even during the manual removal of the placenta during delivery. Now imagine a rhesus negative mother being pregnant with a rhesus positive baby, and any of the above conditions happen, there would be leakage of the baby ’s blood into the mothers' bloodstream, this would cause the mothers' guardian angel I tried to describe earlier ( antibodies) to fight the foreign blood. The immune response is usually slow and weak in the first pregnancy, so the mother’s antibodies may not have much effect on the baby, and the baby may escape.

When a subsequent pregnancy occurs, and any of those conditions peculiar to pregnancy happens that lead to leakage of the baby’s blood occurs, it would lead to a total destruction of the baby’s Red blood cell by the mother’s antibodies leading to the disease hemolysis of the unborn! The baby is usually born dead. The risk increases with each pregnancy and some people out of ignorance may have no idea why they have been having stillbirths. They may be wrongly diagnosed as a case of secondary infertility if proper history is not taken.

WHAT TO DO WHEN YOU ARE RHESUS NEGATIVE

From the above discussion, it can be seen that the women are really the ones at the receiving end; well the men can have problems when they are rhesus negative and are being transfused with a rhesus positive blood. But this is very rare.
As a woman, it is important for your doctor to know your rhesus status during your antenatal care for him to be able to help you out appropriately

• If you are fortunate to have a rhesus negative husband, then he might probably not intervene, but there are some schools of thought that postulate a chance of the baby being rhesus positive. (This is rare!)
• If a woman is rhesus negative and marries a husband who is rhesus positive, then the risk is high as I already described. However, the good news is that there is an injection called rhogam that can be given to prevent the antigen-antibody interactions. (Guardian angel fight).

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This is preferably given at about the 7 months of pregnancy (28weeks) and also just before delivery (36 weeks). When the baby is born, another dose is given at about 72hrs after delivery to prevent the problem.

• It is also important to do an early scan to know the approximate date of delivery, this is to enable the rhogam injection to be given at the right week during the antenatal care.

CONCLUSION.

For those girls that don’t know if they are rhesus negative or positive, this is another great lesson to learn from. What if you did not know that you were rhesus negative and you pregnant for your boyfriend, and he asked you to abort it and you heeded to his advice?
Reading through this write-up, I would assume you have learned all about rhesus iso-immunization in the simplest of terms.

REFERENCES

• Heredity of the Agglutinogen Rh.-American Journal of Clinical Pathology, Volume 15, Issue 9, 1 September 1945, Pages 405–406.

• The Incidence of Abortion in Nigeria- International Perspectives on Sexual and Reproductive Health, A journal of peer-reviewed research, Volume 44, issue 4,December 2015, pages 170-181

• Management of Rh Disease and Isoimmunization

• Blood groups- NHS
• image sources

Thanks for reading..

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