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Department
Biochem. and Medical Genetics
Course
BGEN 3020
Professor
Jason Leboe- Mcgowan
Semester
Fall

Description
Lecture 4 blood types ABO/Rh incompatibility ABO incompatibility: If blood group O woman have a baby, the mom will have a problem with ABO incompatibility b/c mom already have an Ab that can cross the placenta (blood group O people have anti A IgM, anti B IgM and anti AB IgG, normally). Normally, there is an anti AB IgG Ab which can cross the placenta, and attack an A or B RBC. So, there could be a problem in the very first pregnancy. Example: mom is blood group O negative and baby is blood group A negative. Is there an incompatibility of blood groups? Yes. Is there an incompatibility in Rh groups? No. Just the blood groups, since the mom is O while baby is A. The mom is O, she has anti AB IgG, which will cross the placenta; the A part of the Ab will attach to the A part of the A cells of the baby’s. The baby’s macrophages of the spleen will destroy it, which is Type II HPY, mild anemia, and unconjugated bilirubin which is handled by the mom’s liver; no kernicterus, no probs with jaundice in the baby b/c in utero, the mom’s liver will take care of it. When the baby is born the baby, it will have a mild anemia and jaundice. MCC jaundice in the first 24 hrs for a newborn = ABO incompatibility (not physiologic jaundice of the newborn – that starts on day 3). Why did the baby develop jaundice? B/c the baby’s liver cannot conjugate bilirubin yet and must handle unconjugated bilirubin on its own now, so it builds up. This is an exchange transfusion rxn for ABO incompatibility – most of the time is b9, and put under UV B light. How does UV B light work? It converts the bilirubin in the skin into di-pyrol, which is water soluble and they pee it out (Rx for jaundice in newborn). Anemia is mild b/c it is not a strong Ag and doesn’t holster a brisk hemolytic anemia. If you do a coomb’s test, it will be positive b/c IgG’s on the RBC’s. So always an O mom with a blood group A or AB baby. This can occur from the first pregnancy (not like Rh sensitization where the first pregnancy is not a problem). In any pregnancy, if mom is blood group O, and she has a baby with blood group A or B, there will be a problem (blood group O = no problem). Rh incompatibility Mom is Rh negative and baby is Rh positive. Example: mom is O negative and baby is O positive (not ABO incompatible, but Rh incompatible). In the first pregnancy: deliver baby without going to a Dr, and there is a fetal maternal bleed, some of the babies O positive Ab’s got into my bloodstream, which is not good. So, mom will develop an anti B Ab against it. So, mom is sensitized which means that there is an Ab against that D Ag and now mom is anti D. 1 year later, mom is pregnant again, and still O negative, and have anti D and the baby again is O positive. This is a problem b/c it is an IgG Ab, which
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