Questions: Have you noticed that Carmen and her first child don't have compatible ABO blood groups? Why does an ABO incompatibility between a mother and her child rarely cause severe problems? a) Typically IgM is raised against A and B antigen, which can't cross the placenta b) Binding of IgM to A and B antigens does not cause hemolysis c) Pregnant women don't produce anti-A and anti-B antibodies during pregnancy d) A and B antigens aren't produced until after birth, so aren't attacked in utero

Have you noticed that Carmen and her first child don't have compatible ABO blood groups? Why does an ABO incompatibility between a mother and her child rarely cause severe problems? a) Typically IgM is raised against A and B antigen, which can't cross the placenta b) Binding of IgM to A and B antigens does not cause hemolysis c) Pregnant women don't produce anti-A and anti-B antibodies during pregnancy d) A and B antigens aren't produced until after birth, so aren't attacked in utero
Transcript text: Have you noticed that Carmen and her first child don't have compatible ABO blood groups? Why does an ABO incompatibility between a mother and her child rarely cause severe problems? a) Typically $\operatorname{IgM}$ is raised against $A$ and $B$ antigen, which can't cross the placenta b) Binding of IgM to A and B antigens does not cause hemolysis c) Pregnant women don't produce anti-A and anti-B antibodies during pregnancy d) A and B antigens aren't produced until after birth, so aren't attacked in utero
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Solution

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The answer is the first one (a): Typically $\operatorname{IgM}$ is raised against $A$ and $B$ antigen, which can't cross the placenta.

Explanation for each option:

a) Typically $\operatorname{IgM}$ is raised against $A$ and $B$ antigen, which can't cross the placenta: This is correct. The antibodies that are typically produced against ABO blood group antigens are IgM. IgM antibodies are large and do not cross the placenta, which is why they do not affect the fetus.

b) Binding of IgM to A and B antigens does not cause hemolysis: This is incorrect. IgM can cause hemolysis if it binds to A and B antigens on red blood cells, but this typically occurs in transfusion reactions, not in the context of pregnancy, because IgM does not cross the placenta.

c) Pregnant women don't produce anti-A and anti-B antibodies during pregnancy: This is incorrect. Pregnant women can produce anti-A and anti-B antibodies if they are of a different blood type than their child, but these are usually IgM antibodies, which do not cross the placenta.

d) A and B antigens aren't produced until after birth, so aren't attacked in utero: This is incorrect. A and B antigens are present on fetal red blood cells during pregnancy. However, the antibodies that could attack them (IgM) do not cross the placenta.

In summary, the reason ABO incompatibility between a mother and her child rarely causes severe problems is primarily due to the nature of the antibodies involved (IgM), which do not cross the placenta.

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