In Rh incompatibility, maternal IgG antibodies cross the placenta and opsonize fetal red blood cells, which are then destroyed by splenic macrophages through phagocytosis (extravascular hemolysis), distinguishing it from ABO incompatibility which involves complement activation.
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The Rhesus Trap Why Red Blood Cells Die 🩸| Immunology 101Added:
An Rh negative mom is pregnant with her second Rh positive baby. Her antibodies attack the fetus. But how do the red blood cells actually die? If you said complement activation, you just fell for a classic board trap. Massive complement activation is for incompatibility.
Rh incompatibility is driven by IgG antibodies. These cross the placenta and opsonize or coat the fetal red blood cells. The baby's own splenic macrophages recognize these coated cells and eat them via phagocytosis.
This is extravascular hemolysis.
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