Many people also have a so called Rh factor on the red blood cell's surface. This is also an antigen and those who have it are called Rh+. Those who haven't are called Rh-. A person with Rh- blood does not have Rh antibodies naturally in the blood plasma. But a person with Rh- blood can develop Rh antibodies in the blood plasma if he or she receives blood from a person with Rh+ blood, whose Rh antigens can trigger the production of Rh antibodies. A person with Rh+ blood can receive blood from a person with Rh- blood without any problems.
Development of hemolytic disease of the newborn
The most common problem with Rh incompatibility, hemolytic disease of the newborn, may arise during pregnancy. Normally, no direct contact occurs between maternal and fetal blood while a women is pregnant. However, if a small quantity of Rh+ fetal blood leaks across the placenta into maternal bloodstream of an Rh- mother. Upon exposure to Rh antigen, the mother will start to make anti-Rh antibodies. Usually, the first born baby is not affected. During a subsequent pregnancy the maternal antibodies cross the placenta into the fetal blood. If the second fetus is Rh+, the ensuing antigen-antibody reaction causes agglutination and hemolysis of fetal RBCs and result hemolytic disease of the newborn.
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