Different blood type in mother and child. What does a blood type conflict mean during pregnancy. Manifestations of hemolytic disease

The article explains the risk of Rhesus conflict during pregnancy. Recommendations are given to future parents on the prevention of possible complications.

Having become pregnant, the woman becomes registered in the antenatal clinic. She has to go through a lot of examinations, take tests. An analysis will also be required, which will help determine the blood types of future parents and their Rh factors.

The Rh factor is a specific property of human erythrocytes, which is due to the presence of an antigen protein. Other group systems do not affect the presence of the Rh factor in the blood. Every person is born with a certain Rh factor. It remains unchanged until death and is inherited by children.

How is the Rh factor determined?

Rh factor in medicine is indicated by a combination of two Latin letters Rh. If Rh antigen is detected in red blood cells, then the blood of such a person is considered Rh-positive (Rh +). There are about 85% of such people in the world. The remaining 15% are carriers of Rh-negative blood

Rh-negative people do not experience any particular inconvenience and are not considered sick. But if a woman is going to become a mother, then she needs special attention.

If an antigen and an antibody of the same name are present in the blood, then their combination leads to a gluing reaction of erythrocytes

Glued together red blood cells are unable to carry out the function of delivering oxygen. Antigen and antibody of the same name do not occur in the bloodstream of healthy people.

Rh-conflict occurs when mixing Rh-positive blood with Rh-negative. The blood of the fetus becomes incompatible with the blood of the mother. All systems of the mother's body will fight against the foreign protein that has appeared in it.

This happens when the father's Rh is inherited, with immunological incompatibility of blood groups: maternal and child. With incompatibility of blood groups, the danger is less than with incompatibility of the Rh factor.

Rhesus affiliation is determined in several ways. It depends on whether special laboratory equipment is available. In its absence, express methods for determining the Rh factor are carried out:

• using a universal reagent; tube does not heat up
• on a white flat plate without heating the test tube

Rh-affiliation is determined by fresh, unclotting blood. It is taken from a finger or from a vein

For the express method, universal serum is used, which is suitable for all blood groups. Whey is prepared in a special way. It is used during the procedures of iso-immunization of pregnant women. The agglutination of red blood cells in a test tube indicates that there is an Rh antigen in the blood.

The body of a mother with a negative Rh perceives a fetus that has inherited a positive Rh father as foreign. As a result, antibodies are produced that attack and destroy the fetus.

Sometimes this affects the development, normal growth of the baby. But serious consequences are also possible: antigens present in the blood can cause intrauterine death of the fetus, miscarriage

Rh conflict symptoms

On her own, a woman cannot determine by her well-being that she is at risk of developing an Rhesus conflict. The main symptom is the presence of antibodies in her blood

• the fetus develops a hemolytic disease, which is manifested by anemia, a violation of the activity of internal organs
• baby has jaundice
• there is a risk of hypoxic damage to the brain and heart that is deadly to the fetus

Cause of Rh conflict:

• C-section
• various complications, bleeding before or during childbirth caused by placental disorders or its detachment
• performing various procedures such as chorionic biopsy, cordocentesis or amniocentesis
• with preeclampsia, diabetes, after the flu or acute respiratory infections
• after intrauterine sensitization of the expectant mother

A woman is at risk for the development of Rh-conflict in case of complications during pregnancy (toxicosis, jumps in blood pressure, infectious diseases). They will find out about possible sensitization after the woman passes all the tests and the Rh affiliation of future parents and their blood groups is determined

Rh factor blood test

It is impossible to independently find out that a couple does not match each other by blood. But if a woman does not become pregnant for a long time from a partner, or if miscarriages become the outcome of pregnancy, then you should seek help from doctors. An “infertile” couple, having passed all the necessary tests and following the recommendations, will be able to conceive a baby, and a woman will successfully endure it

The first step in the examination of a pregnant woman for the presence of antigens is to determine the Rh-affiliation of future parents. It is recommended to carry out such a diagnosis before conception, or at the beginning of pregnancy. With negative Rh of both partners, further research is not carried out, since the conflict is excluded.

Important: if the patient's pregnancy ended in a miscarriage or there were abortions, the fetus died in the womb, or the baby who was born had a hemolytic disease, then there is a high risk of an Rhesus conflict

To find out if the fetus suffers from a lack of oxygen during the Rhesus conflict, it is necessary to regularly undergo ultrasound diagnostics. Ultrasound is prescribed for the period of the 20th week of pregnancy and ending with the 36th week. The last time an ultrasound is prescribed before childbirth. This allows you to monitor the growth and development of the baby.

The development of the fetus is also judged by examining amniotic fluid (amniocentesis) and examining cord blood (cordocentesis). Diagnosis of this type is carried out in the last trimester of pregnancy. Cord blood analysis, how much anemia develops in terms of hemoglobin, bilirubin, and other indicators.

What do antibodies mean?

In the body of a pregnant woman, compounds of a protein structure - Rh antibodies - begin to be produced only by 7-8 weeks. Prior to this, there are no Rh antibodies in the mother's bloodstream that can harm the fetus.

The first pregnancy is characterized by the production of large antibodies. It is not easy for them to penetrate the placenta to the fetus. But in subsequent pregnancies, other antibodies against the Rh factor are produced.

There are fewer antibodies, but their presence is more detrimental to the baby, since it is easier for them to pass through the placenta and they are more aggressive. Therefore, the female immune system reacts during the subsequent gestation of the fetus to the Rh antigen faster and stronger.

Rhesus conflict in the second and subsequent pregnancies

If a woman is carrying a child for the first time, then the incompatibility of the blood types of future parents will not cause an Rh conflict, since the amount of antibodies produced is insignificant.

A second pregnancy increases the risk of conflict. This means that during childbirth, umbilical cord blood with protective antibodies - "memory cells" enters the mother's blood. Thus, the mother's body becomes susceptible to the Rh antigen. Antibodies cross the placental barrier and destroy fetal red blood cells.

Maximum risk for women

Rh sensitization does not threaten the mother's body. After a difficult pregnancy and childbirth, the mother's problems with the presence of a Rh conflict are exhausted. But the immunization that has occurred can affect the recurrence of the situation during a subsequent pregnancy.

Consequences of Rh conflict for the fetus

A child with a Rh conflict develops hemolytic disease, edema, jaundice appear, the spleen and liver increase. In the blood, the rate of bilirubin increases, which poisons a small body.

Favorable prognosis: a newborn child is likely to develop mild hemolytic anemia. At the same time, jaundice and dropsy are absent.

In more severe forms, hemolytic anemia with jaundice occurs. But the most severe form of the disease is aggravated by both jaundice and dropsy. The baby can die in the womb

Treatment of Rh conflict

Doctors may decide to give the baby an intrauterine blood transfusion up to the 34th week of pregnancy, which improves the condition of the fetus. Transfusion is carried out through the umbilical cord. Thus, it is possible to avoid the development of anemia in the fetus.

In especially severe cases, a decision is made to stimulate preterm labor. A newborn child is treated for jaundice, a course of phototherapy is carried out (with laying out under special blue lamps). Multiple blood transfusions may be needed. In some cases, no treatment is required at all.

Video: about the Rh factor and the threat to the child

The conflict between the blood type of mother and child leads to hemolytic disease.

Why does immunological conflict occur?

There are four blood groups: the first (0), the second (A), the third (B), the fourth (AB). Also, the blood has a Rh factor: it can be positive or negative.

So, if a pregnant woman and her baby have different blood types or Rh factors, it turns out that the baby’s blood contains an antigen that is not in the mother’s blood. This antigen could have come from the father, whose blood type or Rh is different from the mother's.

Thus, the mother's body perceives the fetal blood cells as a foreign formation, and begins to produce antibodies aimed at destroying "foreign" cells.

Normally, the placental barrier prevents the mother's blood from mixing with the baby's blood, but in some pathological conditions (placental abruption, etc.), the functions of the barrier may be impaired.

What is the danger of a blood type conflict during pregnancy?

If the blood of the expectant mother begins to produce antibodies to the baby's blood, then when these antibodies enter the baby's circulatory system, they begin to destroy the red blood cells in the baby's blood.

A blood type conflict can lead to kidney and liver problems, as well as brain damage.

The so-called hemolytic disease develops, the signs of which are anemia and jaundice.

But such serious consequences as disturbances in the functioning of the nervous system, which lead to a lag in the development of the baby in the future, are unlikely and are rare.

Who is at risk by blood type?

It is believed that women with the first blood type are most at risk of blood type conflict.

In addition, those future mothers who are pregnant not for the first time from the same man are at risk of getting a conflict in the blood group.

Rh factor:


Blood types:

First pregnancy with blood type incompatibility

The first pregnancy, which is accompanied by a conflict of blood types, is the safest.

After childbirth, antibodies produced to the baby's blood remain in the mother's body. Thus, in subsequent pregnancies from the same man, these antibodies will continue to be produced, their number will become significantly higher than in the first pregnancy.

Even if the first pregnancy was interrupted by an abortion or there was a premature birth, miscarriage, the female body has already managed to develop antibodies.

Manifestations of group conflict, its treatment and prevention

During the bearing of the baby, there may not be any signs of a blood type conflict. The baby can be absolutely healthy until the moment of birth, when the placental barrier disappears, and mother's blood enters the circulatory system of the crumbs.

A blood test is taken from the newborn to find out if there is a group conflict. If it is, the child will have anemia - a low level of hemoglobin in the blood.

The baby may also develop hemolytic jaundice. Unlike physiological jaundice, which appears a few days after birth, is safe and resolves on its own, hemolytic jaundice is a pathological condition. A baby can be born immediately with yellow skin, or it can turn yellow a little later. Even the whites of the baby's eyes can become yellow. This is caused by a huge excess of bilirubin in the blood, which puts a tremendous strain on the baby's liver.

To treat a child, he can be placed under a special lamp, which, with the help of radiation, will reduce the level of bilirubin. There are also various medicines for this purpose.

In extreme cases, the child may need a blood transfusion.

There is no special prevention against the conflict of blood groups. But to establish the likelihood of developing such a process, both parents take a blood test to determine the group and Rh factor.

Special IV blood group

The fourth blood group in combination with a negative Rh factor is considered very rare. If a woman has this particular blood type, then the likelihood of a conflict with the baby's blood is very high, so the expectant mother will be under close supervision and undergo regular examinations throughout the pregnancy.

Human blood has two important characteristics - blood type (AB0 system) and Rh factor (Rhesus system). Most often, during pregnancy, there are problems with bearing due to incompatibility precisely according to the Rhesus system, so we will analyze it first.

What is the Rh factor?

Rh factor (Rh) is an erythrocyte antigen of the Rhesus system. Simply put, it is a protein located on the surface of red blood cells (erythrocytes).

People who have this protein are Rh+ positive (or Rh positive). Accordingly, a negative Rh Rh- (or negative Rh) indicates the absence of this protein in human blood.

What is Rhesus conflict and why is it dangerous for the fetus?

Rhesus conflict- the immune response of the mother's body to the appearance of a "foreign" agent inside itself. This is the so-called struggle of the bodies of the Rh-negative blood of the mother with the bodies of the Rh-positive blood of the child, which is fraught with the appearance of hemolytic anemia or jaundice, hypoxia, and even dropsy of the fetus.

During the first pregnancy, the blood flow of the mother and child function separately from each other and their blood does not mix, but during previous births (possibly also during abortions and miscarriages), the baby's blood can enter the mother's blood, and as a result, the body of a woman with a negative Rh factor will develop antibodies to the antigen even before the next pregnancy occurs. Therefore, a repeated pregnancy can end at an early stage with intrauterine death of the embryo, and as a result, a miscarriage.

The first pregnancy usually proceeds without complications, since the mother's blood does not yet have antibodies to the "foreign" blood of the child.

Simply put, the blood cells of the fetus penetrate the placenta into the blood of the pregnant woman, and if the blood is incompatible, the body of the expectant mother perceives the baby as a “stranger”, after which the protective reaction of the woman’s body produces special antibodies that destroy the baby’s blood cells.

The destruction of fetal red blood cells by antibodies is called hemolysis, which leads to anemia in the baby. At the same time, the condition of the pregnant woman does not worsen, and the woman is not even aware of the previous threat to the health of the baby.

When does Rh conflict occur during pregnancy?

With a positive Rh mother, the Rh conflict will never arise, no matter what the blood of the father of the child.

With a negative Rh, both future parents also have no reason to worry, the child will also have a negative Rh factor, it cannot be otherwise.

With a negative Rh factor in the blood of a pregnant woman and a positive one in the father of the child, the baby can inherit both the mother's Rh factor and the father's Rh factor.

If the father of the child is Rh-positive, homozygous, and has the DD genotype, the pregnant woman is Rh-negative, then in this case all children will be Rh-positive.

If the father is Rh-positive, heterozygous, and has the Dd genotype, and the pregnant woman is Rh-negative, then in this case a child can be born with both Rh-positive and Rh-negative factors (the probability in this case is 50/50).

Therefore, it is also important for a man to donate blood for the Rh factor with the determination of the genotype with a negative blood group in a woman planning a pregnancy or carrying a fetus.

With the likelihood of developing a Rh conflict, a pregnant woman is prescribed a blood test for the presence of Rh antibodies.

Table 1 - The likelihood of developing a Rh conflict during pregnancy

Judging by the table above, we can say that the Rh conflict occurs only when the pregnant woman is Rh negative and the father of the child is Rh positive, and only in 50 cases out of a hundred possible.

That is, it is not necessary to observe an Rhesus conflict during pregnancy. The fetus can also inherit a negative Rh from the mother, then there will be no conflict.

It should also be noted that during the first pregnancy, antibodies are produced for the first time, and therefore they are larger than during a second pregnancy. It is more difficult for large antibodies of the IgM type to penetrate the placental barrier into the blood of the child, as if they cannot “crawl through” the walls of the placenta, and during the next pregnancy, other, more “modified” antibodies of the IgG type are produced. They are smaller, and their ability to penetrate the walls of the placenta is much higher, which is more dangerous for the fetus. Then the antibody titer rises.

Therefore, primiparous women should not worry about the Rh conflict, just be vigilant (it is enough to determine the antibody titer once a month), and enjoy the pregnancy period, because there are cares for caring for the baby and his upbringing ahead.

Prevention and treatment of Rhesus conflict

During the first pregnancy (that is, there were no abortions and miscarriages in the past), for the first time, an antibody test is performed from 18-20 weeks 1 time per month (up to 30 weeks), then from 30 to 36 weeks - 2 times a month, and after 36 weeks of pregnancy - 1 time per week.

With repeated pregnancy, they begin to donate blood for antibodies from 7-8 weeks of pregnancy. If the titer is not more than 1:4, then this analysis is taken once a month, and with an increase in titer - more often, once every 1-2 weeks.

An antibody titer of up to 1:4 inclusive is considered acceptable (normal) in a “conflict” pregnancy.

Titles 1:64, 1:128 and more are considered critical.

If there is a risk of developing a “conflict” pregnancy, but antibodies have never been detected before week 28 (or were detected, but not more than 1: 4), then later they may appear in significant quantities.

Therefore, for prophylactic purposes, pregnant women at week 28 are injected with human anti-Rhesus immunoglobulin D, which block the work of the woman's immune system to destroy foreign bodies, i.e. after the injection, the woman's body will not produce antibodies that destroy the blood cells of the embryo.

An injection of immunoglobulin is advisable to carry out in the absence of antibodies in the blood of a pregnant woman, since in other cases it is simply useless.

The vaccine does not adversely affect the health of the mother and fetus, it is completely safe.

After the injection (provided that there are no antibodies in the blood shortly before the injection, or at least if their titer is not more than 1: 4), it is not reasonable to donate blood for antibodies, since a false positive result may be observed.

It is also advisable to monitor the baby's cardiac activity by regularly conducting cardiotocography (CTG), starting from the 26th week.

Doppler or doppler is an ultrasound examination of blood flow in the vessels of the fetus, in the uterine arteries and the umbilical cord.

If the fetus suffers, the blood flow velocity (V max) in the middle cerebral artery will be higher than normal. When this indicator approaches the mark of 80-100, an emergency CS is performed in order to prevent the baby from dying.

If there is an increase in antibodies, and the child's health is deteriorating, then this indicates the development of fetal hemolytic disease (abbreviated GBP), then it is necessary to carry out treatment, which consists in intrauterine blood transfusion of the fetus.

With a "conflict" course of pregnancy during an ultrasound examination, the following signs of hemolytic disease of the fetus can be observed:

• an increase in the abdomen of the fetus due to the accumulation of fluid in its abdominal cavity, as a result of which the baby takes the “Buddha pose”, spreading the bent legs to the sides;
• edema of the subcutaneous fatty tissue of the head (ultrasound shows a “double contour” of the fetal head);
• an increase in the size of the heart (cardiomegaly), liver and spleen;
• thickening of the placenta up to 5-8 cm (normal 3-4 cm) and expansion of the umbilical cord vein (more than 10 mm).

Due to increased swelling, the weight of the fetus will increase by 2 times compared to the norm.

If it is not possible to conduct a blood transfusion, then it is necessary to discuss the issue of early delivery. You can’t hesitate, and if the baby’s lungs have already formed (the 28th embryonic week or more), then it is necessary to perform labor stimulation, otherwise the pregnant woman risks losing the baby.

If the baby has reached 24 weeks, then a series of injections can be given to ripen the lungs of the fetus so that he can breathe on his own after an emergency delivery.

After the baby is born, he is given a replacement blood transfusion, plasmapheresis (blood filtration from dangerous cells) or phototherapy, otherwise the destruction of the baby's red blood cells will continue.

Modern generic resuscitation service is able to leave a premature baby even when he is born at the 22nd week of pregnancy, so in a critical case, entrust the saving of the baby's life to qualified doctors.

Group incompatibility of mother and fetus

Less often, but still there is incompatibility by blood type.

Blood type is a combination of surface antigens (agglutinogens) of erythrocytes of the AB0 system genetically inherited from biological parents.

Each person belongs to a certain blood type according to the AB0 system: A (II), B (III), AB (IV) or 0 (I).

This system is based on a laboratory analysis for the determination of two agglutinogens (A and B) in human blood.

• I blood group - otherwise it is group 0 (“zero”), when neither A nor B agglutinogens were found on red blood cells during a blood test for group affiliation.
• Blood type II is group A, when the erythrocytes contain only A agglutinogens.
• Blood type III is group B, that is, only B agglutinogens were found.
• The IV blood group is the AB group, both A and B antigens are present on erythrocytes.

Group incompatibility is often observed if the future mother has the I blood group, and the future father of the child has the IV-th, then the fetus will inherit the II or III blood group. But there are other options for incompatibility by blood group (see table 2).

Table 2 - The likelihood of developing a conflict in blood type during pregnancy

Usually, group incompatibility proceeds much easier than Rhesus, so the blood type conflict is considered less dangerous, and babies who have had a blood type conflict are born with ordinary jaundice, which soon disappears.

Oksana Krutsenko

When registering with a antenatal clinic, a future mother receives many referrals for tests. One of the analyzes is the determination of the group and the Rh factor not only of the pregnant woman, but also of her spouse.

If earlier the main emphasis was on determining the Rh factor in order to avoid the Rh conflict, now they are trying to minimize the possibility of an immunological conflict in blood types. Incompatibility arises because the 1st blood group has α and β antibodies in its composition, and the A and B antigens in the rest of the erythrocytes. As soon as foreign antigens meet each other, they begin to destroy foreign erythrocytes. There is a blood type conflict.

Dangerous states

It is worth fearing the occurrence of incompatibility by blood group during pregnancy if the mother and child have the following combinations:

• the fetus has group IV - the mother has all the rest;
• in fetus II - in mother I or III;
• in fetus III - in mother I or II.

A dangerous condition almost always occurs if a woman with blood group I develops a fetus with II or III. In case of repeated pregnancy, such a combination requires mandatory monitoring, since there is a risk of hemophilia in the newborn.

Compatibility of blood groups during pregnancy is most difficult to achieve for women with group I, regardless of the Rh factors. If a man belongs to another group, then there is already a high risk of an immunological conflict.

Women with other groups are compatible with men of their "category" and those with group I.

Future mothers who have had miscarriages or non-developing pregnancies in the past, have children with pathologies: mental retardation or diseases of the circulatory system should be under special supervision. The risk of a dangerous condition increases in women who have had blood transfusions in the past.

Negative and positive blood type during pregnancy

It is believed that if the mother has a negative blood type, carrying a pregnancy is always problematic. This is far from true.

If both partners do not have a mismatch in the Rh factor or the Rh factor is the same in the blood of the child and mother, no conflict is observed, and it is possible to endure the baby without complications - from this side.

There is no trouble when the mother has a positive status, and the fetus has a negative one.

If the situation is reversed, then antibodies may begin to be produced in the mother's blood to destroy foreign proteins and there will be a threat of termination of pregnancy.

Treatment is necessary. Injections of anti-D-immunoglobulin will help stop the Rh conflict. Despite the fact that during gestation they try not to prescribe any medications, such therapeutic measures are necessary to stabilize the condition. Therapy does not have a negative effect on the development of the fetus.

If it was possible to convey the pregnancy, but the necessary therapeutic measures were not taken, the process launched by the production of antibodies continues after the birth of the baby.

Hemolytic disease appears, in which the work of the hematopoietic system is disrupted.

Blood type conflicts

Hemolytic disease in a newborn also occurs with the development of an immunological conflict in blood groups. But - unlike the Rhesus conflict - this condition appears much less frequently. The placental barrier protects the bloodstream of the fetus from the penetration of antibodies. The risk of penetration of foreign proteins increases during childbirth.

Suspicion of an immunological conflict arises if the newborn has anemia, edema is visually visible, an ultrasound examination notes that the liver and spleen are enlarged, the jaundice does not go away for a long time.

To prevent hemolytic disease immediately after childbirth, women with a negative Rh or with a positive blood group, if no treatment was carried out during pregnancy, take blood from a large vessel of the umbilical cord for analysis. They find out the status of the child and compare it with the status of the mother, at the same time determine the level of bilirubin.

If necessary, treatment is prescribed. Sometimes blood sampling from a baby is performed during the first day after a few hours to determine the changes during the adaptation period in dynamics.

special group

Gynecologists very carefully monitor women with IV negative blood group during pregnancy.

Since carriers of this group are quite rare - especially in combination with a negative Rh factor - immunological conflict often occurs. If incompatibility is detected from the very beginning, then observation is established immediately, and at the first symptoms of blood incompatibility with the embryo, the necessary therapy begins.

However, she can achieve success only during the first pregnancy - doctors do not advise carriers of this blood type with a negative Rh factor to tempt fate and try to become pregnant again. Incompatibility threatens not only the health of the baby, but also his mother, and repeated births can end in serious problems for her.

However, no one can forbid a woman to give birth, and if from the very beginning she is registered and the condition is monitored in dynamics, there is a chance of having a healthy baby. True, if the baby is female, the opportunity to transfer “ dangerous blood" to him increases.

Most pregnant women have heard about the Rh conflict. But not everyone knows that the mother's blood type may not match the child's blood type. However, such situations happen at least as often as Rhesus conflict. And you need to be ready for them.

If the expectant mother has the first blood group, and the father of the child has the second, third or fourth, in the antenatal clinic they can prescribe an analysis for group antibodies (hemolysins). This is done to determine if the mother and baby have a blood type conflict.

What is an immunological blood type conflict?

There are four blood groups. The blood of all groups, except for group I, contains antigens A or B in its erythrocytes. In the same blood plasma (except group IV) there are antibodies α or β.

• I (0) - antibodies α, β, does not contain antigens
• II (A) - antigen A, antibodies β
• III (B) - antigen B, antibodies α
• IV (AB) - antigens A and B, does not contain antibodies

When A and α or B and β meet, the antibodies destroy red blood cells containing the "enemy" antigen. This is how a blood type conflict (or AB0 conflict) develops.

During pregnancy, an AB0 conflict occurs most likely if the woman has I blood type, and the baby inherits II or III.

Conflict? Let's decide!

In this case, in response to the antigens contained in the baby's blood, as well as in the placenta and amniotic fluid, group antibodies begin to be produced in the mother's body, which destroy foreign red blood cells and release hemoglobin (this process is called hemolysis). Such an “attack” can occur during pregnancy and during childbirth.

As a result of a conflict over the Rh factor, hemolytic jaundice sometimes develops with an AB0 conflict, when the newborn's liver cannot cope with a large amount of bilirubin (hemoglobin is excreted from the body in the form of this substance). To be prepared for such a development of events, after the 30th week of pregnancy, the expectant mother may be prescribed a blood test for group antibodies, which will need to be repeated regularly with an interval of 1 month. Cord blood is taken immediately after delivery. It shows what, and the level of bilirubin in the baby's blood (if there is still a conflict). Further actions of doctors depend on the degree of hemolytic disease.

Unlike the Rhesus conflict, a blood type conflict can develop in the first pregnancy, but in subsequent ones it happens less often.

If you and your husband have the prerequisites for an ABO conflict, you should not panic: it usually proceeds much easier than the Rhesus conflict, and, as a rule, does not pose a danger to the baby's health.

Some expectant mothers during pregnancy more often than others need to donate blood for analysis. Why? Are you one of them? Let's figure it out

There are many unsolved mysteries in modern science. One of them concerns hematology - the science of blood. Why do people with different blood types live on Earth? What is the Rh factor for? .. There are still no answers to these questions. But we are on our way to a solution. If earlier the blood conflict between a woman and her fetus was a huge threat to the child, now medicine has learned to solve this problem. The main thing is timely diagnosis!

Four options

When registering at the antenatal clinic, the doctor will send you for a number of tests, including the Rh factor.
After receiving the results, the doctor will ask you to name the group and Rh of the father of the unborn child. Bringing the data together, he will tell you about the likelihood of a conflict between you and the fetus.
Can the blood of two close people, which you and your baby are, “quarrel”? Unfortunately yes. After all, she has her own tasks - to maintain the vital activity of the body and not let strangers into the “house”, which are the components of blood that differs in group and rhesus.
There are four blood groups with the following designations: I \u003d 0 (zero), II \u003d A,
III = B, IV = AB.
So, you have in your hands the results of the analysis. Now you can calculate with which group the baby can be born. Make it easy. Suppose you have IV (AB) group, and your husband has I (00). Let's solve a simple problem:
AB + 00 = A0 (II), A0 (II), B0 (III), B0 (III).
Now it becomes clear that the baby will be born with a second or third blood type.
All possible inheritance options are as follows:
I + I = I
I + II \u003d I, II
I + III \u003d I, III
I + IV \u003d II, III
II + II \u003d I, II
II + III \u003d I, II, III, IV
II + IV \u003d II, III, IV
III + III \u003d I, III
III + IV \u003d II, III, IV
IV + IV \u003d II, III, IV
But is the blood type of the future mother determined only for this purpose? Of course not. The main reason is to find out what kind of blood she can transfuse in an emergency. In addition, based on the analyzes, the possibility of a conflict between the mother and the fetus is assumed.
Most often, blood type incompatibility occurs when the mother has group I, and the baby has group II or III (accordingly, the child's father should have the second, third or fourth group).
But such conflict is rare. More often it is not possible to "make friends" with Rhesus.

simple equation

The Rh factor is another indicator of blood. If present, it is said to be positive (Rh+). Was it found in the blood? Then it is called negative (Rh-).
In principle, it does not affect the life and health of an adult in any way. But they begin to pay special attention to him if the pregnant woman has Rh- blood, and the father of the child has Rh +. In this case, the baby can inherit a positive Rh father, which means that a Rh conflict with the mother is possible. In what way does it manifest itself?
Just as with incompatibility by blood group, the mother's body begins to produce antibodies that can destroy the erythrocytes of the fetus.
Let's calm down! During the first pregnancy, a conflict due to the incompatibility of the mother and fetus in terms of blood type and Rh factor rarely develops (if there have been no abortions and miscarriages before). But with each subsequent pregnancy, the likelihood of conflict increases.
Knowing this, doctors have learned to prevent the formation of antibodies. So, all Rh-negative women who do not have antibodies to the Rh factor at 28 weeks of pregnancy, in the interval between the 28th and 34th weeks, the introduction of anti-Rhesus immunoglobulin is indicated. In Ukraine, it can be purchased at blood transfusion stations (domestic) or in a pharmacy (imported, higher quality).

Is there a conflict?

Suppose you have a possibility of a conflict in terms of blood type or Rhesus (and possibly in two indicators at once!).
Usually a progressive conflict does not affect the woman's well-being. How to determine that the negative process has started? Donate blood regularly to determine the amount (titer) of antibodies in the blood, namely:
up to the 32nd week - once a month;
from the 32nd to the 35th - twice a month;
after the 35th - every week.
If antibodies in the blood are found in small quantities, you will have to visit the laboratory more often (tracking the dynamics).
Titre high? Most likely, the woman will be admitted to the hospital, where, first of all, a detailed ultrasound will be performed. Thickening of the placenta, polyhydramnios, as well as an increase in the size of the spleen and liver of the fetus, the accumulation of fluid in his tummy can be manifestations of the conflict. In exceptional cases, doctors may perform amniocentesis (abstraction of amniotic fluid from the fetal bladder under ultrasound control). Yes, the procedure is unpleasant and unsafe, but sometimes only in this way it is possible to reliably determine the density of water, the titer of antibodies to Rh, as well as. With a high density of amniotic fluid, which indicates the breakdown of fetal red blood cells, they decide how to conduct a pregnancy.
It is possible to carry out cordocentesis (taking blood from the umbilical vein under ultrasound control).

Action plan

This is not your first pregnancy and a high titer of antibodies has been detected in your blood? Have other studies confirmed the existence of a conflict? We need to start treatment! Usually it consists in intravenous infusion of vitamins, glucose solution. To reduce the amount of antibodies in the mother's blood, the doctor will prescribe immunoglobulin injections.
The gestation period is short, and the titer is constantly growing? Such a mother will be offered to undergo plasmapheresis. The essence of the method is to take the mother's blood in a volume of 250-300 ml, then the formed elements (red and white blood cells) are returned back, and the withdrawn liquid part (plasma) of the blood is replaced with therapeutic solutions - albumin, rheopolyglucin. It is as if a mechanical purification of the mother's blood from the antibodies contained in the plasma is carried out. This method of treatment is used from the second half of pregnancy.
It is extremely rare to prescribe hemosorption (removal of toxic substances from the blood using a special apparatus) and intrauterine transfusion of Rh-negative blood of the same group to the fetus from 18 weeks.

How do we give birth?

If antibodies are not detected during pregnancy or they are found in small quantities, then childbirth is carried out in the usual way. The only caveat: it is recommended to cut the umbilical cord immediately, without waiting for the pulsation to stop.
Did the conflict manifest itself shortly before the birth? Mom is hospitalized to constantly monitor the amount of antibodies. If the increase is significant, and the condition of the crumbs worsens, then stimulation of labor or a caesarean section are indicated.
After the birth of the baby, the neo-natologist will immediately take care of it. The necessary studies will be carried out and treatment will be prescribed to eliminate his anemia, jaundice, and edema.
Did you have a chance of a conflict, but no antibodies were found during pregnancy? Within 48 hours of giving birth, you should be given an immunoglobulin injection to prevent conflict in subsequent pregnancies!