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Rhesus Negative
This information leaflet has been produced by Gateshead Health NHS Foundation Trust Maternity
Unit to provide information to pregnant women who are Rhesus Negative
What does being rhesus negative mean?
Rhesus factor is the name given to a special protein or antigen, which is attached to the surface of
the red blood cells. Approximately 15% of people do not have this, and are known as being Rhesus
Negative (RhD negative), like you. The 85% who do have this antigen are known as being Rhesus
Positive (RhD positive). The lack of this antigen does not affect the health of the person, but
occasionally, problems can arise if a mother has a different Rhesus factor from her baby.
Why is it important to know if I am rhesus negative?
Rhesus status is important during pregnancy. If blood cells from a Rhesus Positive baby get into the
bloodstream of a Rhesus Negative mother, she will react by producing Anti-D antibodies as though
the baby’s blood was a foreign body. The most common time for this to happen is during birth, but it
can happen at other times during pregnancy. This is not usually dangerous in a first pregnancy, but in
later pregnancies, these antibodies can cross the placenta (afterbirth) and attack the blood cells of a
Rhesus Positive unborn baby. This can cause ‘Haemolytic Disease of the Newborn’, or HDN, which can
be very mild, but which is only detectable by blood tests in a laboratory.
Each year in England and Wales, around 500 babies will develop HDN. It can cause anaemia and
jaundice, but in severe cases, it can cause a baby to be stillborn or severely disabled.
How is HDN treated?
An injection is given to Rhesus Negative mothers in order to prevent HDN. The injection, Anti-D
Immunoglobulin (or Anti-D injection), contains antibodies, which destroy any Rhesus Positive red
blood cells passed from baby to mother before the mother’s system has time to recognise the foreign
bodies, and produce her own.
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What is Anti-D immunoglobulin?
Anti-D Immunoglobulin, or Anti-D, is made from plasma in the blood, and is collected from donors. It
is screened to reduce the risk of passing on viruses from the donor to the person receiving the
injection.
Are there any risks with Anti-D?
Anti-D has been used for many years and is thought to be very safe. Occasionally, it may cause an
allergic response in the mother, but this is very rare. For this reason, you should stay in the surgery /
clinic for about 20 minutes following the injection, and if you do feel unwell, you should inform the
midwife immediately.
When would I receive Anti-D?
To prevent HDN occurring, the National Institute of Clinical Excellence (NICE), a government agency,
recommends that all Rhesus Negative mothers have a blood test to screen for antibodies at 28 weeks
of pregnancy and that a routine injection of the Anti-D be given between 28 and 30 weeks. In
Gateshead, a single dose of 1500IU is administered.
It is also important to be given Anti-D following a late miscarriage, termination of pregnancy,
amniocentesis, chorionic villus sampling, external cephalic version (turning the baby head down), any
vaginal bleeding during pregnancy and after any abdominal trauma, such as a fall or road traffic
accident. In these circumstances, your midwife or doctor will discuss this further with you.
Following delivery, the midwife will obtain blood from yourself and the umbilical cord to check the
baby’s blood group, and this will tell us if further Anti-D is needed. If it is, this will need to be given
within 72 hours of the baby’s birth.
What if I decide not to have the Anti-D injection?
Even if you decide not to receive the Anti-D injection during your pregnancy, you will still be offered
the blood test to identify the presence of any antibodies in your bloodstream. This would be done at
28 weeks, following the birth of your baby, or at any stage of your pregnancy where you experience
vaginal bleeding.
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How can I find out more information?
Please discuss any queries or concerns with your midwife or consultant during your appointment;
alternatively if you need any more information please do not hesitate to contact the Maternity
Pregnancy Assessment Unit to speak to a midwife.

Pregnancy Assessment Unit (24 hours 7days)
0191 445 2764
0191 445 3678
National Institute for Clinical Excellence (NICE)
11 Strand,
London.
WC2N 5HR
www.nice.org.uk
NHS Direct:
Tel: 0845 46 47
www.nhsdirect.nhs.uk
Data Protection
Any personal information is kept confidential. There may be occasions where your information needs
to be shared with other care professionals to ensure you receive the best care possible.
In order to assist us improve the services available your information may be used for clinical audit,
research, teaching and anonymised for National NHS Reviews. Further information is available in the
leaflet Disclosure of Confidential Information IL137, via Gateshead Health NHS Foundation Trust
website or the PALS Service
REFERENCE:
NICE (2008) Routine antenatal anti-D prophylaxis for women who are rhesus D negative. NICE
technology appraisal guidance 156
Information Leaflet:
Version:
Title:
First Published:
Last Reviewed:
Review Date:
Original Author:
Reviewed by:
No IL75
6
Rhesus Negative
February 2007
August 2015
August 2017
Modern Matron
Midwife
This leaflet can be made available in other languages and
formats upon request
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