Anti-Rh immunoglobulin after childbirth - When and why? This introduction of antibodies does not harm the fetus, mother or newborn.

Anti-rhesus immunoglobulin during pregnancy, it is prescribed in case of a threat of miscarriage of the fetus. During pregnancy, there is a decrease in the body's defenses in order to preserve the fetus - immunity weakens. However, there are times when the threat of rejection (miscarriage) still becomes a serious problem that requires medical intervention. This situation occurs against the background of a conflict between the Rh factor of the mother and the fetus. Let's consider in detail.

Rh factor

In case of incompatibility of groups according to the Rh factor (negative and positive), the destruction of the red blood particles of the fetus occurs, leading to termination of pregnancy. During the first pregnancy, problems usually do not occur, because the blood of the fetus does not mix with the circulatory system of the mother's body.

However, during subsequent pregnancies, the mother's body begins to perceive the fetus as a foreign dangerous element, and the immune system attacks. The immune system begins to produce antibodies (immunoglobulins) that destroy the embryo's red blood cells.

Women at risk include:

multiparous;
having an abortion;
who gave birth to dead children;
having spontaneous miscarriages;
having an ectopic pregnancy;
undergone obstetric surgery;
undergoing blood transfusion.

How does the conflict of the Rh factor manifest itself? The main symptoms are:

newborn jaundice;
anemia of the newborn/fetus;
dropsy of the newborn / fetus;
neonatal/fetal thrombocytopenia
neonatal/fetal death.

Important! The introduction of the drug before childbirth is carried out in without fail. After childbirth, the drug is administered in the case of the birth of crumbs with a positive Rh factor.

Indications for use

Achievements modern medicine made it possible to find protection against the conflict of Rh factors. The introduction of immunoglobulin changed clinical picture V better side. When a Rh conflict is detected, a woman is injected with a drug ("Resonativ"), which prevents a dangerous case of fetal rejection immune system mother. The scheme of drug administration looks like this:

the first vaccination / dropper - at the age of the fetus 28-32 weeks;
the second vaccination - after childbirth (after 72 hours).

Vaccination is also administered in the following cases:

after a miscarriage;
after an abortion;
at ectopic pregnancy;
during gynecological operations.

The vaccine does not pose a threat to the fetus, it is administered intramuscularly or intravenously. The dosage is selected in accordance with the condition of the pregnant woman and the presence of intrauterine bleeding.

After the introduction of immunoglobulin, there may be consequences in the form of:

short-term hyperthermia;
dizziness and nausea;
allergic manifestations;
shock (in rare cases).

Important! Self-treatment with immunoglobulin is not safe!

pharmachologic effect

The preparation of anti-Rhesus immunoglobulin for a dropper is a colorless (or yellowish) liquid in ampoules. The active substance for vaccination is produced from the blood of donors who have successfully passed the test for the presence of antibodies.

The drug is indicated for women with a negative Rh who are at risk after:

childbirth with positive group blood;
abortion from a husband with a positive group.

The introduction of immunoglobulin prevents the production and development of antibodies in the mother's body. As a result of the following births in the mother:

antibodies to the child's blood will not appear;
the fetus will fully develop;
will not arise stressful situation fear of childbirth.

Prevention

Women with a negative group must be careful before and after childbirth:

avoid invasive procedures;
do not perform artificial termination of pregnancy;
check the compatibility of the group during blood transfusion;
conduct sensitization to fetal erythrocytes.

Women with a negative group should regularly check the presence of anti-Rhesus immunoglobulins before delivery.

Important! Anti-Rhesus vaccination is widely practiced in our country, however, the effect of the vaccine on the body has not been fully studied. The question "to do or not?" remains unanswered. Each future mother must decide on its own, for or against. Great importance when choosing an answer, he has confidence in his personal obstetrician-gynecologist.

Baby feeding

How to feed a newborn if the mother rhesus negative, and at the husband positive? Breastfeeding is allowed in the following cases:

if the child is the firstborn;
if the mother was injected with immunoglobulin after the first birth.

In mother's milk, antibodies are detected about three days after birth. If an anti-Rh injection was not given to a woman with a negative blood type, then a newborn with a positive Rh factor may suffer from feeding.

A mother's negative blood type is not a sentence for having children from an Rh-positive man. Many women have been able to bear and give birth to healthy newborns, so there is no need to panic prematurely. For more information about the negative Rh factor during pregnancy, watch the video:

Serum anti-rhesus immunoglobulin Do pregnant women need vaccinations or can they wait? Rubella vaccine before pregnancy - an opportunity to avoid complications

Not always the process of having a baby goes as smoothly as we would like. Rh factor incompatibility between fetus and mother serious problem and quite uncommon. Its consequences can threaten the life of newborns. According to statistics, ninety percent of situations appear if the mother has Rh minus, and the child has Rh plus. This happens much less with incompatibility due to other factors.

Anti-Rhesus immunoglobulin after childbirth is administered as a preventive measure to prevent the development of abnormalities and complications of this type or after termination of pregnancy for different stages. Consider why this tool is intended, what effect it has and how effective it is.

If a woman has a negative Rh, then this indicates that there are no certain proteins on the surface of her red blood cells. According to statistics, 15% of people on planet Earth experience this, and this is considered the norm. In a situation where the fetus in the womb has Rh-positive blood, its red blood cells are saturated with such proteins. This is the difference from the mother's blood cells.

During the period of "position" and delivery, several milliliters of plasma and the baby's uniform elements enter the woman's vessels. As a result, the body of the “pregnant woman” actively reacts to these foreign cells and, at the same time, antibodies are formed. In turn, antibodies enter the womb to the fetus and at the same time kill those very Rh-positive red blood cells. This is how anemia can develop in a child.

The consequences of such a process can be very serious, it is possible that intrauterine death of the fetus may occur.

To prevent this from happening, immunoglobulin is prescribed. This is a remedy that in its composition has components that can bind the baby's Rh-positive red blood cells in the mother's blood. It turns out if at the time of its introduction a woman has red blood bodies fetus, then they are destroyed without disastrous outcomes for the body.

But there are some nuances that must be observed in order for these preventive actions were effective:

The introduction of an injection is done both when carrying a child, and after childbirth with a negative Rhesus. For prevention hemolytic disease.
When a woman has symptoms and signs of an Rhesus conflict during pregnancy, there is no point in injecting the drug. The disease can no longer be prevented in this situation. And for future pregnancies.
It is necessary to inject immunoglobulin within 72 hours after the birth of the baby.

Experts believe that the sooner this is done, the better. Since during childbirth or termination of pregnancy, the blood bodies of the crumbs are thrown as much as possible.

If antibodies to the baby's red blood cells have formed in the patient's body, the introduction of immunoglobulin will not give results, because the chain reaction has already begun.

Who needs

Immunoglobulin is prescribed to patients if they are diagnosed with an Rh-negative factor.

A number of indications for administration:

After the first birth in women in labor with Rh (-). Sometimes, immediately after birth, the group and Rhesus are determined in the newborn, and if it is Rh (+), the mother is given an injection of immunoglobulin after childbirth. This is also done after the second birth. After the following, it is considered that it is not necessary to use it, because immunization has already occurred or, for certain factors, it has not been and will not be.
After an ectopic pregnancy.
If the woman in labor had placental abruption.
When my mother received transfusions of Rh-positive blood.
After miscarriages.
After premature delivery with an unfavorable result.

This drug can really insure against the development of a subsequent Rh conflict with her future baby and prevent bad consequences.

In order to be positive results, it is advisable to follow some rules:

Inject the medicine strictly according to the indications and under the supervision of specialists, including during pregnancy.
After delivery, the earlier it is used, the more likely it is to have an effective result.
Basically, the instructions indicate a permissible time interval of 72 hours. But be careful, some funds must be used within 48 hours.
Doctors adjust the amount of medication administered depending on the expected blood exchange between mom and baby. The usual standard dose is 200-300 micrograms (that's about 1-1.5 ml), but after surgery caesarean section, manual separation of the placenta and other factors, the volume of the dose should be increased by 1.5-2 times. In another case, all red blood cells in the patient's body will be bound, and an immune response will also develop for the remaining portion.

If the patient's husband also has a negative Rh, then you should not worry. Your child under such circumstances will also be negative and there will be no conflict. Antibodies will not harm Rh-negative children.

Reasons not to do

This is considered standard manipulation, but sometimes anti-Rhesus immunoglobulin is not used after childbirth. This is possible in the following cases:

When a woman is the third in a row or next birth. Physicians believe that such preventive measures should be carried out last time after the birth of the second child.
If the newborn is also Rh negative. In this case, there is no conflict. But a similar reaction may occur when further pregnancies if the fetus has a different group.
When a woman in labor has contraindications to this remedy, for example, an allergic reaction.
Suddenly, there is no medicine in hospitals, in clinics, the gynecologist is obliged to warn and advise to purchase, explaining all the possible outcomes in this case.

Complications

This injection is an intramuscular injection. After use, there are such complications and problems as:

Allergy, even if such hypersensitivity has never been noticed before. If you develop a rash on your body, trouble breathing, swelling, or other signs, tell your health care provider right away. Possible Quincke's edema, urticaria or anaphylactic shock.
Redness, pain, swelling may appear at the injection site. Sometimes this place itches.
Sometimes there is deterioration general condition body (nausea, vomiting, fever bodies).
It is not excluded that HIV and hepatitis can be transmitted, despite the fact that careful selection of donors is carried out and repeated and different ways medication checks. Therefore, it is advised to do a control examination for these infections (about six months later).

If you are interested in questions: whether to inject this medicine or not, whether it will harm, then the answer is this: if you do not administer the medicine, then the outcome can be a hundred times worse and sadder! Whatever it is, it's up to you!

Rhesus conflict between mommy and fetus is a rather serious condition that threatens, first of all, the health, and sometimes the life of the baby. Choice medicines to fight similar states not big enough so important role has developmental prevention. If you use the tool according to strict recommendations, carefully observe all the conditions, then you can prevent the development of pathologies and abnormalities.

Anti-Rh immunoglobulin is used to prevent Rhesus conflict during pregnancy.

Approximately 85 percent of people have Rh positive blood. This means that on the surface of their red blood cells there is a specific protein - Rh.

During pregnancy in a woman who does not have such a protein (negative Rhesus), if the child inherits a positive one from the father, an Rhesus conflict is possible.

For this, fetal erythrocytes must be in the mother's blood, which can be with pregnancy complications, invasive intervention, injuries abdominal cavity. The risk increases if this is not the first birth or there have been abortions. The woman's body perceives children's erythrocytes as foreign proteins and starts the mechanism for the production of antibodies against them.

The consequences of the Rhesus conflict

With a high concentration of antibodies, the baby's red blood cells are destroyed, the oxygen supply to tissues worsens, which leads to hypoxia, which primarily affects the brain and kidneys. In milder cases, it is limited to anemia and "jaundice", in severe cases, fetal death is possible.

Hemolytic disease is treated with intrauterine blood transfusion and/or preterm delivery.

During the first pregnancy, if it passes without complications, the Rh conflict usually does not occur. M-type, large, not falling into the fetus and not harming it. But during the birth itself, the child's red blood cells can enter the bloodstream of the woman in labor, and if there are enough of them, the mechanism for the production of G-antibodies will start. This happens about 10% of the time, and then when next pregnancy at positive Rh factor germ conflict is inevitable.

If the pregnancy was interrupted or there was a miscarriage for more than eight weeks, then the appearance is also possible. This is due to the fact that the fetus is already producing its own red blood cells, and they can enter the woman's blood.

Prevention and anti-rhesus immunoglobulin

Treatment of a developed rhesus conflict requires highly qualified doctors, sophisticated medical equipment and does not guarantee avoiding negative consequences for the health and development of the baby. Therefore, prevention is needed, which is simple and affordable, although it requires the exact implementation of all recommendations.

For prophylaxis, anti-Rhesus human immunoglobulin is used, it is produced from donors and contains passive Rh antibodies. The principle of action is based on the simultaneous presence of foreign Rh proteins and passive immunoglobulin antibodies in the blood, which blocks the launch of the mechanism for the production of its own active antibodies.

Indications for use during pregnancy

The instructions for the preparation contain all the necessary information. invert Special attention necessary for indications for use:

negative rhesus in the mother;
Rh positive father
lack of production of Rh antibodies in the mother.

Only with the simultaneous presence of all three conditions can immunoglobulin be used for prophylaxis during pregnancy.

During the initial visit to the antenatal clinic, a blood test for the Rh factor is done, with negative result a pregnant woman is placed on a special account. held once every two weeks, at the end of the term weekly. Their presence in small quantities is not critical, but a sharp increase indicates the development of the Rhesus conflict. For prevention, it is necessary to administer an intramuscular dose of immunoglobulin at 28–29 weeks, the second vaccination is given after childbirth, if the newborn has a positive Rh.

intravenously;
at high level antibodies in the blood, i.e. after the start of the Rh conflict;
children.

Indications for use in other cases

Immunoglobulin should also be used in Rh-negative women.

after childbirth, if the child is Rh positive;
after termination of pregnancy.

The injection is given within 2 hours after the event, up to 48-72 hours is acceptable. Immunoglobulin in these cases provides normal flow next pregnancy, suppressing the possible triggering of the mechanism for the production of antibodies against the Rh protein.

after injuries of the abdominal cavity during pregnancy;
with an ectopic pregnancy;
after invasive (microsurgical) interventions;
with infections, diabetes, pregnancy complications with the risk of fetal red blood cells entering the mother's bloodstream.

Application notes

At medical indications V antenatal clinic an injection at 28 weeks of gestation should be free. The standard dose compensates for the entry of 15 ml of red blood cells or 30 ml of whole blood into the woman's bloodstream. Available in vials or syringes. Before use, the solution is kept at room temperature within 2 hours. An open vial is used immediately and is not stored.

Choice of immunoglobulin

There are several types of anti-Rhesus immunoglobulin on the market, which differ in name, manufacturer and price:

HyperROW S/D, USA
Partobulin SDF, Austria
CamROW, Israel
Resonative, Austria
BayRowDee, USA
Immunoro, Russia
Human immunoglobulin Antirhesus, Russia

The opinions of doctors and user reviews on sites do not give a clear answer which immunoglobulin is better, everyone has arguments for and against. Imported drugs are considered to be of higher quality, the price for them is correspondingly higher, but the active ingredient is the same for everyone.

Solival 01/16/2009 at 01:48:36 PM

Who was not injected with anti-Rhesus immunoglobulin, but it was necessary?

Was it necessary?
After miscarriages? abortion? childbirth! tell?

The situation - I am Rh-negative, my husband is Rh-positive.
The pregnancy was uneventful, there were no antibodies. Childbirth - emergency CS at full disclosure. Small - with daddy's blood.

Immunoglobulin DO NOT Prick. I asked the doctor - he said no need, they say, anyway, Bush will give birth in 3 years.
Then there were other problems, did not sharpen ...

Are you thinking now? What to eat and where to run? need to donate blood for antibodies? and then what? Should I inject it during pregnancy?

Sorry, if not in this topic ... Something no one reacts

Shakira 01/20/2009 at 00:20:39
I have already written 100 times and I will write again)))) it really pissed me off then! I was injected only after my scandals and +
I, as it were, by the way, asked the doctor with whom (by agreement) I gave birth, and when will I be injected with it myself ??? Fortunately, I read a lot and knew what I needed.
Then the doctor began to groan and sigh, complaining that he (immunoglobulin) was not available, that I would not give birth soon (they say, in 5 years, where will you be, where will I be) and quietly mentioned that, in general, immunoglobulin should be injected 72 hours after childbirth, i.e. the conversation was late in the evening on Sunday and on Monday at 16 o'clock the deadline expired!
there is no medicine in the maternity hospital, according to the certificate - no, the small one screams in the ward, they don’t let her go out with her - you can’t go along the corridors with a child ...
someone dropped that there is a transfusion center, my mother calls - I need a certificate from the maternity hospital that I need ... They refuse to write ..
The husband is being killed on the ground floor - they don’t let the closed maternity hospital, I run in after the birth ... my husband’s mobile phone is discharged, the nurses hold me by the breasts, I try to transfer my battery (the phones are the same)
As a result, they gave some kind of scribble (I, standing under the office, heard how the head of the department asked someone on the phone - why should she deal with such garbage?) and gave a medicine box with a price of 300 UAH - my mother called the manufacturer, they answered that they do not sell to private individuals , she burst into tears and the man on the other end of the wire took pity - he gave the address of the pharmacies that they buy from them, one of them was next to her husband's work ... it cost 117 UAH
They work hard 2 hours before the end of the term with a view - well, you got us sick ...
The head of the department told me that my husband called her a bitch...
Well, who are they after this??
so insulting, so far, well, honestly ...
Jussy 01/16/2009 at 01:55:08 PM
at all
immunoglobulin should be injected on the first day after birth, then it's too late.
- Solival 01/16/2009 at 01:57:04 PM
  the question is what to do now?
  can't go back...
  in principle, there is a possibility that there are no antibodies - for the small one was breastfed. If they were, it would be bad...
  - Jussy 01/16/2009 at 01:59:13 PM
    To do nothing
    you just answered yourself :)
    - Jussy 01/16/2009 at 02:00:27 PM
      I know that in the first pregnancy there is a very small chance of antibodies
      more in the second, more in the third.

Misfit 01/16/2009 at 03:58:03 PM

Do not worry.

Just control the level of antibodies during the second pregnancy - and if they are not, then at the 28th week you will have to enter immunoglobulin, and everything will be all right. And besides, your second child may well be with a minus, so it’s not at all a fact that there will be any problems at all.

I am Rh negative. Two children. In the interval between them there was an abortion, after which nothing was injected to me. The first child is negative, the second is positive. Antibodies were never detected.

Mom Ksenia and daughters - Katyusha (01/04/1999) and Sashenka (12/08/2007)

Solival 01/16/2009 at 04:00:46 PM
hope for the best
I won't risk the second...
- Barbolis 16/01/2009 at 17:35:42
  my parents are in this situation.
  my brother was born positive, and although it was the first pregnancy (there had been no abortions before), my mother's antibody titers went off scale, but she gave birth to a healthy brother. earlier, immunoglobulin was not administered due to its absence. and when my brother was 8, she gave birth to me, there were no antibodies during pregnancy, in the maternity hospital I was diagnosed with a negative Rh. It turned out that I was Rh positive. in short everything is confusing. and I write all this for what - there may be a lot of exceptions to the rules. don't bother. medicine is evolving. and even if the antibody titer rises during the next pregnancy, they will help you cope with this
  It's better to regret what you did than what you didn't do but could have done.

On the surface of erythrocytes - red blood cells that carry oxygen from the lungs to the tissues of the body, and in the opposite direction - carbon dioxide, contains a protein called the Rh factor.

Its presence is inherited - 85% of the population has this protein, and the blood of such people is considered Rh-positive. But the remaining 15% of people do not have this protein, so their blood is called Rh-negative.

The health of people with Rh-negative blood is not at all different from the health of people with Rh-positive blood. The presence or absence of the Rh factor matters only in some cases: during blood transfusion and during pregnancy.

Rhesus conflict - what is it?

If the blood of the future mother and father has the same Rh factor, that is, the blood of both is Rh-positive or Rh-negative, then for the fetus there are no bad consequences it won't have. If the mother's blood is Rh-positive, and the father's blood is Rh-negative, and the child inherits his blood, that is, Rh-negative, this will also not have any negative consequences.

But if mother's blood is Rh-negative, and the child receives father's blood - Rh-positive, there will be a Rh-conflict. After all, during childbirth, the blood of the fetus in a small amount enters the bloodstream of the mother (5 - 15 ml). The same thing happens with an ectopic pregnancy, abortion, during a miscarriage, with a transfusion, for example, with bleeding, Rh-positive blood to a woman with blood with negative Rh factor.

The woman's body reacts to a foreign protein and gives an immune response, producing antibodies to it. Moreover, during the first pregnancy, the immune response in most cases is not very strong and not as dangerous as in subsequent pregnancies. Indeed, in the future, a woman with Rh-negative blood will produce more and more antibodies.

What danger is the Rh conflict for the fetus?

What happens: in response to the Rh factor of the fetus, antibodies to this protein are produced in the mother’s blood, which enter the blood of the fetus through the placenta, causing the breakdown of red blood cells. The consequence of this is damage to the brain of the fetus, its kidneys, liver, the development of hemolytic disease.

Rhesus conflict can cause miscarriage, the birth of a premature or stillborn child, the birth of a child with jaundice, which requires an immediate blood transfusion.

Note that for women with Rh-negative blood who have not had an abortion, who have not had a miscarriage or an ectopic pregnancy, in which the blood of an Rh-negative fetus could enter their bloodstream, the first birth is likely to be successful. , because antibodies will only begin to be produced and will not yet have time to cause harm. But the second pregnancy can end badly.

Of course, the condition of the newborn to a large extent depends on the amount of antibodies developed in the mother's blood. If there are too many of them, the fetal body will not have time to produce red blood cells. As a result, his liver and spleen increase, intrauterine anemia develops.

Why is anti-rhesus immunoglobulin administered?

To avoid the aforementioned problems, women with negative Rh blood after childbirth, abortion or miscarriage should have their blood tested for antibodies. If antibodies are detected, an injection of anti-Rhesus immunoglobulin should be given. The purpose of such an injection is to suppress the mother's defense system in response to the entry of fetal red blood cells into her blood and prevent the production of antibodies.

Anti-Rhesus immunoglobulin is a ready-made antibody, the first dose of which is administered to a woman at the 28th week of pregnancy. The next one is within 72 hours after birth (if the baby's blood has a positive Rh factor).

The introduction of anti-Rhesus immunoglobulin does not harm anyone - neither the fetus, nor the newborn, nor the mother. However, with each subsequent pregnancy, the administration of antibodies must be repeated at the same time, since they only have an effect on the pregnancy during which the treatment is carried out.