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Tests are done during early stages of pregnancy, and if the mother is Rh -ve and the child is Rh ve, then an injection which prevents the mother’s immune system from generating antibodies against Rh D antigen is given during pregnancy.This will ensure that the fetus remains unaffected by the fact that the mother’s blood is Rh negative and ensures a safe delivery of the child.So, if the father is Rh positive and mother is Rh negative, then extra care should be taken during pregnancy.If the mother’s immune system has prior knowledge of Rh D antigen, either due to some previous blood transfusion of Rh ve blood group, or if this is not the first pregnancy and the earlier pregnancies carried a Rh positive child, then chances are that the mother’s immune system is already aware of Rh D antigen and has antibodies against it ready, which can be of an immediate concern for the fetus health.
While the ABO classification is based on the two antigens A and B, the Rh group has 50 antigens!Most humans have Rh D antigen, and are hence Rh positive. So what caused this mutation where some humans stopped having this antigen in their blood? It is interesting to note that Rh -ve or the absence of Rh D producing genes is common in the European population, even though it is rare in rest of the world.This suggests that there might be an evolutionary advantage in this European population over NOT having Rh D antigen, than having it.The reason for the importance of this antigen is that a mismatch in the D antigen can prove fatal during blood transfusion, just like it does in AB antigen mismatch.So A ve means a blood group which has A antigen and Rh D antigen.
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Which is why in case of an emergency when there is no time to match for any other antigen reactions, O-ve is the safest blood transfusion that can be done without any prior tests because of the absence of A, B and Rh antigens in it.