Rhesus parents. How do the chances of conception depend on the blood type? The impact of negative Rh on the health of the baby

Naturally, you need to know your RH to always be ready for any force majeure, but nevertheless, the percentage of good births in Rh-negative women is very high, especially in the absence of the D antigen and the father of the child.

Blood during pregnancy at a later date should be taken frequently in order to detect the pathology in time and proceed to eliminate it.

During the first pregnancy, the chance of pathology due to the Rh factor is extremely small, because the immune system the mother has not yet formed a system of antibodies to the D antigen in the fetus, and with minimal therapy, the birth will go smoothly.

There may be a risk of a lack of blood in the child, but a conventional transfusion can solve this problem. IN this case a woman should be under the strict guidance of a gynecologist in order to avoid problems with the fetus.

At a certain point in pregnancy, there is a period that is characterized by a peak in the production of specific antibodies to the fetal antigen. At this point, you can make one injection, which is called immunoglobulin. It belongs to the gamma globulin fraction and its function is to prevent the development of maternal antibodies to the fetus in the future. This is very useful if parents are planning a second pregnancy.

If you do not administer this drug to a woman, then with the advent of a second pregnancy, the likelihood of a Rh conflict increases significantly and carries consequences much more terrible than mild form anemia in the newborn. We are talking about a very terrible pathology - hemolytic disease. All red blood cells are susceptible to destruction, the level of bilirubin rises and jaundice can be observed. The fetal brain is also damaged. The chance to give birth to a healthy child, even if necessary assistance very small.

It is worth appreciating the importance of the immunoglobulin vaccine after the first pregnancy, because there are often cases of artificial termination of pregnancy, because in some cases, bearing a fetus is not humane in relation to parents or a baby. If an abortion was performed on a woman who has a negative Rh factor, then a new pregnancy should not be discussed, because the consequences can be fatal.

Medicine does not stand still, and immunoglobulin very well solves the problem with the developed antibodies of the mother to the fetus. Therefore, you need to make your plans for pregnancy in advance and in consultation with your doctor.

Features of the management of pregnant women with negative Rh

Pregnant women who are suspected of having a Rhesus conflict with the fetus need to go to bed as soon as possible in order to constantly be under the round-the-clock supervision of doctors who, in which case, will be able to provide the necessary emergency assistance.

But there is also the possibility that the pregnancy will be completely normal. The reason for this may be reduced level immunity in the mother, who will not be able to develop in a short time required amount antibodies in response to fetal antigens. But this has its drawbacks, because with a weak immune system, there is a high risk of infectious and viral diseases that can adversely affect pregnancy.

Antibodies should be monitored at least once a week. This will help to diagnose the Rh conflict in a timely manner and take urgent action to save the mother and baby.

It is worth noting that the negative Rh factor during pregnancy depends on the blood type. That is, it can be argued that blood type and pregnancy are directly proportional to each other. Negative blood group during pregnancy main reason Problems. So, 1 negative blood group and 3 negative blood group cause Rh-conflict more often than group 2. The third group, although it does not occur often enough, but the chance of a Rh conflict, if present, is very high. With the 4th blood group, the Rh conflict does not occur, since there is no reason in the form of agglutinins. The fourth blood type of the mother is the most favorable, and it is with the fourth group that you can not be afraid to become pregnant.

Rhesus conflict has on the fetus Negative influence, the consequences of which he can remain for life.

• diseases of the blood and cardiovascular system;
• diseases of the liver and gallbladder in the form of hepatitis and jaundice;
• diseases of the nervous system;
• increased risk of diseases that have a hereditary predisposition.

But do not despair. Modern medicine has found more than one method of dealing with the Rh conflict, pregnancy with a negative Rh factor is possible and the consequences are not terrible if you follow some important rules.

Prevention and treatment of negative Rh factor

A few decades ago, women with negative Rh factor recommended to give birth to only one child, and doctors were categorically opposed to terminating the pregnancy with the first baby.

Today, the situation is completely different, which cannot but rejoice. With the help of preventive methods with a negative blood group in a woman during pregnancy, she has the opportunity to freely plan for the birth of the following children.

1. It is necessary to eliminate the production of specific antibodies by the woman's body or reduce their number.
2. It is necessary to abandon certain procedures that increase the risk of fetal blood entering the mother's circulatory system.
3. Use immunoglobulin injections if needed.

• appointment of a blood test for the presence of antibodies in the first trimester of pregnancy;
• with a high titer, you need to repeat the tests every week;
• constant monitoring of the fetus through tests and ultrasound examination;
• if it is impossible to carry out a blood transfusion to the fetus, then it becomes necessary to induce labor, since any delays are dangerous for the life of the baby;
• a woman should be vaccinated only after cases such as abortion or conception outside the uterus.

It is important to remember that during the first birth, the child is most often not in danger if the woman did not receive transfusions of Rh-positive blood. The second birth is much more dangerous in terms of the occurrence of pathologies, but this can be avoided if the woman is given immunoglobulins in time.

Don't panic, because modern medicine has gone far ahead and the problem with a negative Rh factor during pregnancy is easily solved. The main thing is that you need more time to be under the supervision of doctors and monitor your health and the health of your baby.

The topic of the negative Rh factor worries not only the expectant mother, but also many who are preparing to become parents. There is an opinion according to which a negative Rh is considered almost a sentence to infertility.

To what extent this is true, let's try to figure it out. And let's start with the main thing - we will define the concept of the Rh factor.

What is the Rh factor

The Rh factor is detected through a blood test. In fact, it is a protein in the blood - it is present on the surface of blood cells. If this protein is not present in the blood, a person is diagnosed with a negative Rh factor.

It's quite normal phenomenon. According to statistics, every fifth woman has such a Rh factor and is a happy mother.

Experts say that a negative Rh factor is considered individual sign person, such as the color of the eyes and hair, and not at all a pathology, and even more so not a diagnosis of "infertility". Why, then, do many pregnant women make a problem out of a negative Rh factor? And the problem can only be in the presence of a Rhesus conflict.

When does Rhesus conflict occur?

Rhesus conflict is called the incompatibility of the blood of mother and child. If the pregnancy test is confirmed, the woman should immediately register with the gynecologist. The first analysis that a pregnant woman undergoes will be an analysis of the compatibility of the Rh factors of the mother and her baby. And the result of this analysis will significantly affect the course of pregnancy, the outcome of childbirth and the health of the child.

When the rhesus of the mother and baby do not match, there is an rhesus conflict. What happens in such cases?

Suppose the baby inherited a positive Rh factor from his father. Then the body of a pregnant woman with a negative Rh begins to react to the blood of the child, as to a foreign substance. As a result, antibodies are produced that begin to attack the baby's blood, destroying the red blood cells of the unborn child.

Advice. To avoid unnecessary worries, at the first visit to the gynecologist, both parents should donate blood. If a problem of Rh factors is found between partners, it is necessary to consult experienced specialists.

The consequences of the Rhesus conflict

Without medical intervention Rhesus conflict can cause serious consequences. In the blood of the child, an excessive amount of bilirubin begins to be produced. This substance stains the baby's skin in yellow, and the newborn may develop jaundice. In addition, bilirubin can damage the fetal brain, provoke hearing and speech disorders.

With the constant destruction of red blood cells in the blood of an infant, his liver and spleen are forced to accelerate the production of red blood cells, while they increase in size. A low red blood cell count can also cause anemia. There are cases of congenital dropsy (swelling) of the fetus, and sometimes even its death. This is why Rh-negative women often miscarry.

It is important to know that a negative Rh during pregnancy has a similar outcome in only 30% of cases. All other expectant mothers with Rh-negative blood are not in danger.

Second birth with negative Rh

Doctors have determined that the Rh conflict at the birth of the first child is much less common, since the blood of the mother and fetus at the first contact contributes to the production of IgM antibodies, which have quite large sizes. They rarely enter the blood of the fetus, so they do not cause problems.

However, any contact with incompatible blood (miscarriage, abortion, first birth or blood transfusion) gives a woman immunity to the Rh protein. That is, in the future, she will form even more antibodies tuned against the Rh fetus.

Therefore, with a negative Rh, the second pregnancy is much more likely to have adverse consequences. To avoid a negative development of events, after the birth of the first child, a woman is injected anti-rhesus immunoglobulin.

Thanks to this drug, the production of aggressive antibodies is suppressed, respectively, the risk of an Rhesus conflict is minimized.

Introduction of immunoglobulin

Antirhesus immunoglobulin- This is a drug that prevents the production of anti-Rhesus antibodies, which promotes the binding and removal of already formed antibodies from the body. The introduction of this drug prevents the development of Rh conflict during pregnancy.

In addition, immunoglobulin is administered to prevent the occurrence of immune conflict in subsequent pregnancies. Prophylaxis with immunoglobulin is done after:

ectopic pregnancy;
in the first days after childbirth;
spontaneous miscarriage;
amniotic fluid analysis;
abortion;
blood transfusions;
detachment of the placenta.

Remember, a different Rh blood of mother and baby is not a disaster. The reaction of the body is successfully controlled with the help of drugs. The main thing is to do everything on time.

How to plan a pregnancy with a negative Rh

As already mentioned, a negative Rh factor does not significantly affect the first pregnancy, since the woman still has a low level of antibodies. However, their number will increase with each subsequent pregnancy. Therefore, doctors do not recommend terminating the first pregnancy with a negative Rh.

The probability of Rh-conflict with each new pregnancy increases by 10%. Without immunoglobulization for Rh negative, doctors usually recommend interrupting a second or third pregnancy, since the constant destruction of red blood cells will have a detrimental effect on the central nervous system baby.

In such cases, the chance to give birth to a healthy child is reduced to zero. Often there are complications such as missed pregnancy. Most often, fetal death occurs in the first three months or in last trimester pregnancy.

Prevention and treatment of Rhesus conflict

When planning a family, the husband and wife should know not only their Rh factor, but also their blood type.
If the Rh of the parents matches, there will be no reason to worry.

If the father positive rh, and at future mother negative, she should have a blood test periodically. This will help doctors keep the level of antibodies in the blood under control and not miss the moment of the occurrence of the Rhesus conflict. During the first 32 weeks of pregnancy, blood is given once a month, and then until the very end of pregnancy - every week.
In the event of a Rh conflict, doctors will use various measures to save the child. It can be premature birth, baby blood transfusion. Such an operation is performed in the first 36 hours after the birth of the baby.

To reduce the risk of Rh conflict in subsequent pregnancies, vaccination with immunoglobulin is carried out. If for some reason immunoglobulin was not administered prophylactically, it is administered during pregnancy.

Summing up all that has been said, we highlight the main thing - Rh negative during pregnancy- this is not a sentence. If you pass the tests on time and follow all the established recommendations of the doctor, the pregnancy will be easy and the desired, healthy baby will be born soon.

As a rule, the presence of a negative Rh factor in the blood causes some concern among the fair sex. Particular attention is paid to the negative Rh factor in women planning a pregnancy. Doctors do not recommend a second pregnancy to such mothers, and an abortion is practically a sentence of childlessness.

Many believe that Rh negative women should not marry an Rh positive man because the consequences can be daunting. Actually it is not. Currently, medical scientists have made great progress in the study of this issue. Now doctors have learned to cope with the consequences of the presence of a negative Rh factor in the expectant mother, which in the recent past brought great grief to women.

Some people are interested in the composition of blood and know that a special type of protein is present on the shell of red blood cells. It determines the Rh factor. Almost two-thirds of the world's population of the European race has this protein. Such people are carriers of the Rh-positive factor. The absence of protein on the membrane of red blood cells indicates a negative Rh factor. Interestingly, there are about 7% of Rh-negative people of the Negroid race on the planet. And among the population of the Mongoloid race, there are only 1% of such representatives.

Of course, a woman who has a negative Rh factor and is planning to conceive a child should always remember this and monitor her health more carefully. The combination of a "negative" mother and a "positive" father sometimes threatens to cause an Rhesus conflict. But this doesn't always happen. Rhesus conflict occurs when the blood of the unborn child inherits the Rhesus of the father and becomes a stranger to the mother.

In this case, the baby's blood enters the mother's blood through the placenta. The body of a pregnant woman perceives such a phenomenon as the penetration of substances harmful to the health of the mother. The immune system begins to produce antibodies, the purpose of which is to provide reliable protection maternal organism. Mother's antibodies, having penetrated to the child through the placenta, begin an attack on red blood cells. At the same time, the amount of bilirubin in the blood increases. As a result, the fruit becomes yellow. Due to the fact that red blood cells die, the spleen and liver begin to work in an enhanced mode. They increase in size and there comes a time when these organs cease to perform their function. The result is anemia.

Of course, such protective actions of maternal antibodies have an extremely adverse effect on the development of the fetus. If a severe form of Rh conflict occurs, a negative Rh factor in women during the period of bearing a child is quite capable of provoking a miscarriage or intrauterine death of a baby. Even if a woman still managed to carry the baby safely, there is a high probability of having a baby with severe malformations. These include serious disorders of speech, hearing, vision, brain function. Congenital edema of the fetus (dropsy), leading to the death of the newborn, is not excluded.

Fortunately, at present, modern medicine is successfully fighting the manifestations of the Rhesus conflict. Today, only 10% of pregnant women have such problems. Gynecologists who monitor the course of pregnancy in expectant mothers with a negative Rh blood factor prescribe special injections of anti-Rhesus immunoglobulin. This allows you to neutralize aggressive antibodies.

A woman who wants to give birth healthy child, should listen carefully and accurately follow the instructions of the gynecologist, do not miss scheduled ultrasound examinations. Do not despair and treat the negative Rh factor of the blood as some kind of defect or disease.

It is important that blood with a negative Rh factor may be needed for blood transfusion. Therefore, it is good to have a personal blood bank, which is conserved and then stored. It happens that in unforeseen cases, literally minutes become decisive.

Negative Rh blood factor is inherited genetically. Knowing the characteristics of the body, you can always cope with the current situation. Take care of yourself!

The Rh factor is a specific protein in the blood (Rh D antigen) that may be present but is not required. It only affects chemical composition blood, which is taken into account when compatible (primarily with transfusion) with other blood, as well as during pregnancy.

Rh factor and Rh conflict

If the Rh antigen D is present in the blood of a person, then his blood is considered Rh positive and is indicated in medical documents (Rh +). If there is no D antigen, then the blood is Rh-negative (Rh-). Approximately 15% of the population of Europe has Rh-, and in Asian and African countries about 5-10%. Such statistics suggest that it is quite difficult for an Rh-negative woman to find a man with Rh- blood. When pregnancy occurs between an Rh- woman and an Rh + man, a Rh conflict may occur.

Rh conflict is the hormonal response of an Rh negative mother to a positive fetal blood. There will be no rhesus conflict, If:

• Father is Rh negative
• The fetus is Rh negative

The only option for a conflict is negative blood in the mother and positive blood in the child.

How often can the fetal Rh factor be positive if the mother's blood is negative? To roughly predict the type of blood of an unborn child, you need to know a little genetics. All signs of the unborn child, including the type of blood, are formed by at least two genes, one from the mother, the second from the father. A positive Rh factor in a person can be homozygous (formed by two Rh positive genes) and heterozygous (one gene is positive, the second is negative).

So, if the mother has Rh- blood, and the father is homozygous positive, then the fetus will have a positive Rh factor. If the mother is Rh- and the father is heterozygous positive, then the fetus has a 50% chance of having both positive and negative blood. According to statistics, in about 10-13% of cases, pairs with different rhesus factor, and only in about 1% of cases there is a Rh conflict, leading to hemolytic disease newborn.

The mismatch between the Rh factors of the mother and father will not affect the conception of a child. It is a misconception that it is more difficult for a woman with negative Rh blood to become pregnant.

Another thing is that a woman with Rh- blood is not recommended to have abortions and it is desirable to avoid natural termination of pregnancy (miscarriages), especially on later dates.

This is explained by the fact that in the case positive blood in the fetus at the time of an abortion or miscarriage, in almost 100% of cases, the blood of the mother and fetus is mixed, and antibodies begin to be produced in the woman's bloodstream aimed at destroying the D antigens present in the positive blood of the fetus.

The developed antibodies remain forever in the woman's blood and can adversely affect the course of subsequent pregnancies. This also explains the increased risk of Rh conflict in subsequent pregnancies.

Now consider the situation where a woman with Rh- is pregnant and the fetus has Rh-positive blood. It is then that the Rhesus conflict can develop. First of all, you should know how dangerous the Rhesus conflict is.

When the baby's blood enters the mother's blood, antibodies to the baby's blood begin to be produced in it, since it is perceived as something alien and the body tries to protect the woman from the "foreign" body. Antibodies begin to attack the blood of the fetus and literally destroy it. Such negative impact on the blood of a child can lead to a disease, namely, hemolytic disease of the newborn (HDN).

Most often, it is expressed in anemia or jaundice of the newborn, and in severe cases it can lead to kidney failure, heart failure, dropsy, edematous syndrome, or even death of the fetus. However, these situations are quite rare, since modern medicine has learned to effectively fight and even prevent Rh conflicts.

Each pregnant woman with Rh- blood, once a month, and at later dates and once a week, donates blood to determine the titer (concentration) of antibodies. If antibodies are not detected, then everything is fine, and there is no conflict. If the analysis reveals the presence of antibodies, then the woman is close observation and the growth of antibody titer is constantly monitored.

Their presence in itself does not mean developing disease fetus. It will start if the mother's blood enters the baby's bloodstream. According to indications appoint additional ultrasonography, which can also show symptoms of hemolytic disease of the newborn. These include:

• Fetal Buddha Pose - when the child is head up, the stomach is enlarged and, as a result, the legs are wide apart, bent at the knees
• Increasing the thickness of the placenta
• Enlargement of the liver and spleen
• Dropsy fetus
• Polyhydramnios

Additional studies are also carried out (fetal blood test, analysis amniotic fluid, a thorough study of the mother's history, etc.), which allow you to unambiguously confirm or refute the presence of a fetal disease. If HDN is confirmed, doctors will determine the most appropriate time for delivery of a woman, most often 35-37 weeks, and also decide on a planned caesarean section.

It is possible to judge the presence of a Rh conflict only by objective data (all kinds of tests, ultrasound, etc.). The mother's well-being in the presence of a Rh conflict can be absolutely normal, and at the same time, any health problems cannot unambiguously indicate the presence of a Rh conflict. In order to avoid Rh HDN, you need to carefully monitor your health, follow the recommendations and prescriptions of a doctor.

Since Rh conflict occurs only when the blood of mother and fetus is mixed, we note when increased risk such a mixture:

• Abortion or ectopic pregnancy
• Miscarriage after 12 weeks or vaginal bleeding. These two factors increase the risk of Rh conflict in subsequent pregnancies.
• When conducting certain studies or procedures (amniocentesis, external rotation of the fetus on the head, etc.)
• Blunt abdominal trauma

All these situations can lead (and in most cases lead) to damage to the placenta, and as a result, the mixing of the blood of the mother and fetus.

With an increase in the titer of antibodies in the woman's blood, she is prescribed non-specific treatment - vitamin therapy and drugs that reduce allergic reactions. With a stable increase in the number of antibodies in the mother's blood, a procedure for cleansing the blood of antibodies (plasmaphoresis) can be prescribed.

If the Rh conflict progresses, then an intrauterine blood transfusion to the fetus can be prescribed. All these measures are taken in order to bring the pregnancy to full term. As soon as the doctor decides that the child can be born, a caesarean section is performed.

There are also methods for preventing Rhesus conflict. These include the introduction of anti-Rhesus immunoglobulin into the blood of a woman, which prevents the formation of antibodies. It is important to remember that it makes sense to administer immunoglobulin only to prevent the formation of antibodies, but if they are already present, the drug will not destroy them, that is, this procedure is offered to those women in whose blood antibodies are not detected.

Exist exact dates administration of anti-Rhesus immunoglobulin - 28-32 weeks of pregnancy. Since the blood of mother and child almost always mixes during childbirth, within 72 hours after childbirth, the woman is given a second injection of immunoglobulin. These measures allow you to get pregnant again without fear of the presence of antibodies in the blood.

In fairness, we note that in most clinics in Russia, immunoglobulin is administered at the request of a woman and for an additional fee (about 8-10 thousand rubles).

But remember that regardless of whether you decide to do paid analyzes and manipulations or not, modern system healthcare in the vast majority of cases avoids serious problems associated with the mother's Rh negative blood, and doctors will do everything possible to ensure that your baby is born healthy.

Home " Life " If the mother is Rh negative baby positive. How is the Rh factor inherited?

Rh factor plays important role when planning pregnancy and bearing a child. For successful course In pregnancy, the Rh factor of a woman is important, because she can face many problems and dangers that await her.

At the first visit of a pregnant woman to a doctor and registration for pregnancy, the doctor without fail takes blood for analysis.

For normal development And wellness The fetus of both parents must be the same Rh - positive or negative. However, nothing terrible will happen if the father has a negative Rh factor, and the mother of the child has a positive one. And only if the mother has Rh negative, then this threatens the health, and even the life of the fetus.

Rh factor: when is it necessary to see a doctor?

In the case of a negative Rh factor of a woman, the father’s blood is also taken for analysis to determine his Rh. best options For Rh negative woman there will be a Rh-negative man. But all the same, there is a danger of an Rhesus conflict, a child can take a positive Rh, despite the "minuses" of the parents.

From the first weeks of pregnancy, women with a negative Rh factor are under the close supervision of doctors and specialists because of the strong risk group.

So why is the difference in Rh factors in parents dangerous?

We will try to explain to you the risks of a "minus" and how to avoid undesirable consequences and dangers.

There is no danger for Rh-positive mothers, even if the child has taken a negative Rh factor. Another thing is when an Rh-negative mother will have Rh positive baby. Exists real threat the occurrence of Rh-conflict, and as a result - severe hemolytic disease of the fetus. The mother's immune system reacts very violently to the baby's red blood cells that have entered the mother's blood, they are considered alien to her, which causes the appearance of antibodies in the woman's blood.

If the concentration of antibodies in the body of a woman is small, then pregnancy can proceed without complications for the mother and child. But if their number is too high, then this can cause hemolytic disease of the newborn. This disease occurs as a result of the penetration of mother's antibodies through the blood to the child. The liver and spleen of the child are noticeably enlarged due to the fight against antibodies and replenishment of the loss of red blood cells.

During pregnancy, a woman must constantly monitor the growth of antibodies in the blood. Every month she takes a blood test, and from the 28th week, doctors take a blood test every 2 weeks. The hematopoietic organs of the child are also under constant control. Doctors use ultrasound to check if the liver and spleen of the fetus are enlarged, which can give a signal that the baby is not well. Previously, in such cases, pregnancy was terminated, now there is a method of intrauterine blood transfusion.

There is a way to prevent the occurrence of Rh-conflict both in the first and in subsequent pregnancies. Two weeks after an antibody test, and if no antibodies are found, the woman is given a vaccine called anti-Rhesus immunoglobulin, which prevents antibodies from forming in the mother's blood. It is administered intramuscularly for a period of 27-28 weeks. After vaccination, a woman no longer needs to be tested for antibodies.

The development of Rh-conflict of mother and fetus

If antibodies are found in the woman’s blood, but according to all tests and examinations, they do not cause any harm to the child, then after childbirth, in order to prevent the appearance of antibodies in subsequent pregnancies, immunoglobulin is administered to the woman within 72 hours.

How to know that a pregnant woman is at risk due to a negative Rh?

Usually, during the first pregnancy, the Rh conflict rarely occurs due to the low concentration of antibodies in the mother's blood. But with each pregnancy, their concentration increases, and the risk of an Rhesus conflict, and, accordingly, undesirable consequences for the fetus, increases several times. Therefore, doctors forbid women with a negative Rh factor from having abortions, especially during their first pregnancy.

It is very important for a woman with a negative Rh factor to carry the first pregnancy and give birth to a baby. If her first pregnancy ended in an abortion, miscarriage, or a miscarriage occurred, then there is a serious risk of an increase in antibodies in subsequent pregnancies. All this is due to the fact that after an abortion or miscarriage, mechanical scraping of the uterine cavity is necessary, as a result of which the blood of the fetus and mother are mixed. As a result, the growth of antibodies in the mother's blood.

Rhesus negative woman after each pregnancy, immunoglobulin is administered, regardless of whether the pregnancy ended with childbirth, abortion or miscarriage, in order to reduce subsequent risks.

Studies have shown that only 15% of people in the world are Rh negative.

What is dangerous hemolytic disease of the fetus?

When the Rh-conflict of the mother and fetus occurs hemolytic disease of the newborn.

There is also a risk of group conflict when the mother has one blood type and the father has another. Therefore, doctors are very interested in the blood group of the father and mother, often prescribe both tests for AB0 after 32 weeks. As a result of such group conflict, the child may develop severe neonatal jaundice.

It is very important to determine the blood type of the child after birth in time to know if it differs from the mother's blood. If it differs, then the child may also develop hemolytic disease, although not in such a severe form as with the Rhesus conflict.

Hemolytic disease is dangerous for the newborn by the development of the so-called nuclear jaundice, when bilirubin in the child's blood reaches an exorbitant concentration. With kernicterus, the child's brain is affected, which leads to irreversible consequences in its further development. A timely replacement blood transfusion will help prevent nuclear jaundice.

Each person has his own blood type, for example, O, A, B, AB, and, accordingly, the Rh factor - negative or positive. These data have importance not only during pregnancy, but also during blood transfusion or during certain operations. An equally important role in the formation of the baby is also played by the blood group and the Rh factor, especially when there is incompatibility between mother and child.

The danger of childbirth

Once upon a time, in women with Rh-negative blood, newborns immediately died or were born too weak. To date this problem can be prevented, as there are special preparations for this. It can be immunoglobulin, which is made from human blood. This injection must be given to the mother at 28 weeks of gestation and must be repeated within three days after delivery if the baby is Rh-positive.

In the event that the newborn has a negative Rh, then immunoglobulin can not be administered. Thus, with the help this drug it is possible to prevent the birth of an unhealthy child or even his death. The incompatibility will then be exhausted.

Rh blood incompatibility

The problem is observed not only when the mother has a positive, and the child has a negative Rh, but also when the opposite is true. If the baby is Rh-positive, and the mother is negative, then incompatibility occurs and the fetus can get sick.

The woman's body also begins to produce antibodies against the child. When such newly formed antibodies enter the baby's blood, they stick together and destroy red blood cells. With each repeated pregnancies, the Rh conflict becomes more and more expressive, and therefore for repeated pregnancies the danger is becoming more and more pronounced. Doctors in such cases recommend giving birth no more than twice, since in the future you can simply not wait for the birth of a baby.

All the impact begins to occur already from the 12th week of pregnancy, since it is from this time that the composition of the blood begins to form in the child, then the effect of the mother's antibodies on him from the side also increases. While the fetus has a lack of red blood cells, hypoxia of tissues and all organs begins to develop, which provokes a violation of blood metabolism. Then nothing is a threat to the mother, but the child may die without even being born.

Diseases of newborns with incompatibility

Since it has already been said above that the danger is mainly for the unborn child, and if he survives in the mother's womb, he can still be born sick. In most cases, an edematous form of hemolytic disease occurs and newborns die in the first hours of life.

Why does incompatibility occur?

If you do not go into medical details, then we can say in a simple way that any blood is individual and when foreign cells get into it, it begins to fight it. This happens in exactly the same way as viral infections when the body temperature rises and the person begins to feel unwell. The same thing happens during pregnancy, when the mother's blood type is not the same as that of the baby. At this time, rejection of foreign cells begins, producing as many protective antibodies as possible. Then the baby begins to get sick little by little more and more, because the strength of the mother's blood cells is greater than his.

In the most significant situations, children are born dead or severely ill and their life expectancy does not exceed a few days. There are cases when children are born completely healthy and the group conflict does not affect their state of health and blood in particular. It also does not affect their life expectancy and general condition.

Pregnancy planning

Therefore, a married couple, before planning a child, must determine the blood group of a woman and a man, so that it is possible to preliminarily make a forecast for the group of the future baby. Such analyzes are quite simple to do and nothing special is required for this. Only your desire and a little patience.

Many factors influence the course of pregnancy. high risks carries a Rh-conflict between mother and fetus. However, not everyone understands the reasons for this phenomenon, which causes fear of the unknown. Therefore, every expectant mother is obliged to know how dangerous the Rh factor is and in what cases the Rh-conflict "mother-fetus" occurs.

Rhesus conflict - what is it?

To understand the essence of the problem, it is important first of all to understand how important the Rh factor is. It is a special protein located on the surface of red blood cells. This protein is present in the blood of 85% of all people, and the rest is absent. Therefore, the first of them are considered the owners of a positive Rh factor, and the second negative.

Thus, it determines the immunological characteristics of the organism and does not affect human health at all. The Rh factor is commonly referred to as Rh+ and Rh-. This term was first introduced in 1940 by scientists Alexander Wiener and Karl Landsteiner. Rh-conflict of the mother and fetus is an immunological incompatibility according to the blood Rh factor in the event that the mother is negative and the fetus is positive. The danger of Rhesus conflict lies in the fact that it can cause intrauterine death of the fetus, stillbirth, miscarriage. This phenomenon can appear in an expectant mother with a negative Rh both during gestation and during childbirth. The immune conflict between the mother and the fetus is manifested if the fetus has inherited Rh + from the father.

Causes of Rhesus conflict between mother and fetus

For the body of the expectant mother, the blood of a baby with Rh + represents serious threat, so it produces antibodies that react to the fetal red blood cells and destroy them. The Rh conflict between mother and fetus is explained by the transplantation penetration of fetal erythrocytes with a positive Rh factor into the mother's blood with a negative indicator.

The immunological conflict is largely due to the outcome of the woman's first pregnancy. During gestation, the Rh conflict can be caused by blood transfusions in which the Rh factor was not taken into account, previous abortions, miscarriages. Also, Rh-incompatible blood of a child can enter the mother's bloodstream during childbirth, so the mother's body becomes susceptible to a negative Rh factor, and the likelihood of an Rh conflict during a second pregnancy increases. The risk of isoimmunization increases with caesarean section. Blood incompatibility can be triggered by bleeding during pregnancy and childbirth as a result of damage to the placenta.

The probability of Rh-conflict on the blood type

The Rh factor is a genetically determined and dominant inherited trait. If the mother is Rh negative and the father is homozygous positive, the child always gets Rh+. In this case, the risk of a blood type conflict is very high. And in the case of heterozygosity of the father, the probability of passing a negative or positive Rh to the fetus is equal.

In the eighth week, hematopoiesis occurs, during which red blood cells are more likely to enter the mother's bloodstream. In this case, the protection of the mother is triggered, since the antigen of the fetus is considered foreign. Therefore, the body of a pregnant woman produces anti-Rhesus antibodies, which causes the Rh-conflict of the mother and fetus. The risk of immunological conflict during gestation is quite small and amounts to only 0.8%, but it is very dangerous, and therefore requires special study and attention. To identify approximately the Rh of the unborn child by analyzing the blood type of the parents will allow forecasting for the Rh conflict during pregnancy. The table clearly illustrates the likelihood of blood incompatibility.

Consequences and threats in case of Rh conflict during pregnancy

The immune conflict between mother and fetus is fraught with serious consequences for the child. Antigens produced by the mother's body, having detected a foreign body with an incompatible Rh factor, penetrate into the blood stream of the fetus through the hematoma placental barrier and destroy the process of hematopoiesis of the child, inhibiting the formation of red blood cells.

This behavior of antibodies can cause extremely dangerous state for the fetus, threatening the life of the unborn child, which is characterized by acidosis, hypoxia, anemia. An excessive amount of fluid accumulates in the baby's body and there is a violation of the development of almost all systems and organs. In the event that measures are not taken in a timely manner, there is a serious intrauterine death of the fetus, stillbirth, the birth of a child with hemolytic disease, which will continue to progress due to the accumulation of anti-Rhesus antibodies in the baby's body, the production of which was caused by the conflict between mother and fetus during pregnancy. It can also cause developmental pathologies, which are expressed in an excessive increase internal organs, brain, heart, toxic damage to the central nervous system.

Symptoms

Rhesus conflict between mother and fetus during pregnancy does not have clinical manifestations and specific symptoms. It is possible to identify the problem only through a laboratory blood test, which shows the presence of antibodies to a negative Rh factor.

In the fetus, blood incompatibility manifests itself in the development of internal organs and body systems, which can lead to its death in the period from 20-30 weeks of pregnancy, as well as to miscarriage, stillbirth, and premature birth.

In addition, a full-term baby may show edematous, icteric and anemic form of hemolytic pathology. Rhesus conflict in the fetus is manifested in the appearance of immature red blood cells in the blood, pathologies in the development of internal organs. Symptoms are determined by the amount of antibodies produced by the mother's body. In a severe form, the disease occurs when fetal edema appears - an increase in the size of internal organs, the appearance of ascites, an increase in the placenta and the volume of amniotic fluid are observed. The mass of the child can be increased up to two times, the disease is often accompanied by dropsy.

Laboratory research

Rh-conflict "mother-fetus" during pregnancy helps to prevent early diagnosis, primarily in the form of detecting the Rh factors of the father and mother before the onset future pregnancy or in its early stages.

The prediction of the Rh conflict is based on data on previous blood transfusions, the course and outcome of the first pregnancy, the presence of abortions, miscarriages, fetal death inside the mother's womb, hemolytic disease of the child, which makes it possible to reliably identify the risk of isoimmunization.

Laboratory blood tests to determine anti-Rh bodies and titer are carried out for all women with suspected Rhesus conflict during pregnancy. Tests should also be taken by the father of the child. If the likelihood of a Rh conflict is high, a pregnant woman should be tested every month. From the 32nd week, laboratory tests are carried out twice a month, and from the 36th - every week until delivery. If a Rh conflict is detected during pregnancy, studies will determine the content of antibodies in the mother's body. The earlier the pathology is diagnosed, the lower the risk of complications, since the effect of the Rh conflict accumulates over time.

Ultrasound and invasive fetal risk assessment methods

In order to diagnose the immunological conflict between the fetus and the mother in more detail, an ultrasound examination is performed at least four times from the 20th to the 36th week of pregnancy, as well as before delivery. Ultrasound allows you to track the features of the development of the fetus, as well as to identify the presence of pathologies.

In the course of the study, an assessment is made of the condition and size of the placenta, the volume of the abdomen of the fetus, amniotic fluid, dilated veins of the umbilical cord.

Additional research methods are ECG, cardiotocography, phonocardiography, which allow you to determine the level of hypoxia in the fetus during Rhesus conflict. Valuable information is provided by invasive assessment methods - the study of amniotic fluid by amniocentesis and umbilical cord blood by cordocentesis. Diagnosis of amniotic fluid allows you to determine the titer of anti-Rhesus bodies, the sex of the child, the maturity of the lungs of the fetus. The exact degree of pathology is diagnosed by cardiocentosis by blood group and Rh factor of the fetus. In addition, studies show the presence of serum protein, hemoglobin, bilirubin, reticulocytes, antibodies fixed on red blood cells.

Treatment

If a conflict between the mother and fetus by blood group is detected, almost the only effective way The treatment is to give blood to the fetus through the umbilical vein inside the mother's womb. The procedure is performed under ultrasound guidance. This measure allows you to alleviate the condition of the fetus, extend the duration of pregnancy, reduce the manifestations of anemia, hypoxia.

To weaken the influence of the Rh conflict, oxygen therapy is also carried out, a course of non-specific therapy is prescribed, which includes vitamins, preparations containing iron, calcium, and antihistamines. If the fetus has a serious condition, then a caesarean section is performed at 37-38 weeks of pregnancy. Also, a pregnant woman is prescribed plasmapheresis, which allows to reduce the content of antibodies in the blood to the red blood cells of the fetus.

After birth, the child is given a replacement blood transfusion to replace decayed erythrocytes and is prescribed treatment for hemolytic pathology - droppers that remove toxic substances from the body and reduce the level of erythrocyte decay, exposure to ultraviolet rays. Treatment requires an intensive course of therapy, observation of neonatologists, sometimes the child is placed in the intensive care unit. Feeding the baby breast milk not recommended during the first 2 weeks after birth in case of hemolytic disease.

Childbirth with Rhesus conflict

Most often, the outcome of pregnancy in the presence of a Rh conflict - Therefore, the task of doctors is to extend the period of bearing a child, to comprehensively monitor the process of its development. For diagnosis throughout the entire period of pregnancy, ultrasound, dopplerometry, and CTG are performed. If further gestation poses a serious danger to the fetus, a decision is made to give birth ahead of time.

In most cases, gestation with a Rh conflict ends with a caesarean section. childbirth naturally are extremely rare and only if the condition of the fetus is assessed as satisfactory and the life of the baby is not in danger. C-section considered the safest and most gentle for the fetus. During childbirth, the presence of a neonatologist is necessary for resuscitation, if necessary. Childbirth should be carried out in a well-equipped room with all the necessary medical equipment and under the supervision of highly qualified doctors.

Preventive measures

The conflict "mother-fetus" during pregnancy can cause severe consequences for a child. That's why great importance have preventive measures aimed at preventing Rhesus conflict and the development of isoimmunization. When transfusing blood, it is important to take into account the compatibility with the donor, it is necessary to maintain the first pregnancy, as well as to prevent abortions. Careful planning of pregnancy is important. The study of blood group, Rh factor will prevent Rh conflict during pregnancy. The blood group compatibility table avoids problems in the future. You should be careful about the course of pregnancy. As a prophylaxis, an intramuscular injection of anti-Rhesus immunoglobulin from a blood donor is used for women with a negative Rh factor and with increased susceptibility to a positive antigen. This drug destroys red blood cells that came from a carrier of a positive Rh factor, thereby reducing isoimmunization and the risk of Rh conflict.

Injections are carried out after termination of pregnancy, miscarriage, surgery to prevent intrauterine pregnancy. Also administered to pregnant women at risk at 28 weeks and 34 again to reduce the likelihood of developing fetal hemolytic disease. And also injections are prescribed within 2-3 days after childbirth, which reduces the risk of Rh conflict in subsequent pregnancies. Immunoglobulin is administered with each pregnancy if the child is likely to be born with a positive Rh factor.

Thus, the Rh-conflict of the mother and fetus is not a reason for terminating the pregnancy. The likelihood of developing an Rhesus conflict is extremely small, so there is no reason to despair. Thanks to modern achievements in immunology, it is always possible to bear a strong and healthy baby.

Rh factor is a certain property of red blood cells, and it is inherent in most people. If a person's blood has this property, then it is called Rh-positive. If this property is absent in red blood cells, it is called Rh-negative.

And if for human health the absence or presence of the Rh factor does not matter, then there are a number of situations, the role of these properties becomes extremely large.

For example, this is very important for a pregnant woman with Rh-negative blood. her child's blood will be Rh-positive, then there is a high probability of developing a conflict, which poses a great danger to the newborn.

Studies show that the Rh factor is inherited, and, in accordance with general laws heredity, the child inherits one trait from mothers, and the second from father, therefore, the group properties of his blood, including the Rh factor, are composed, as it were, of two “halves”.

If a woman's blood is Rh-negative, and her husband's blood is Rh-positive, and these "halves" are in some sense different, then what will happen?

Studies show that the Rh positive factor is able to suppress the signs of the Rh negative factor, which makes it unrecognizable, the consequences of which can be quite important.

For example, a woman has blood Rh negative, and the man Rh positive, but she has a masked Rh-negative trait. The child, inheriting in equal measure, inherits from the father a clear positive and hidden negative factors, but, in combination with maternal negative, the child will have Rh-negative blood.

According to the same laws of heredity, an amazing case is also possible when parents with Rh-positive blood have a child whose blood is Rh-negative.

This is explained by the presence of a latent Rh-negative trait in the mother and father. If they give the child obvious Rh-positive properties, then the baby will have the same Rh-positive blood. However, if both of them reward the child with their masked Rh-negative factors, which in combination become obvious, then a paradox will be observed in which both parents have Rh-positive blood, and the child is Rh-negative.

If both spouses have Rh-negative blood, then the child will have the same blood.. This is a good option, in which the Rhesus conflict will not occur. This coincidence is happy, but rare, since Rh-negative blood is not so common - about 15% among Europeans and no more than 5% among Asians.

But even if a man has Rh-positive blood, the child is not necessarily in danger, and practice shows that most children are born healthy. Talking about the danger, doctors talk about the risk, or the likelihood of an Rhesus conflict.

During pregnancy, the mother and are combined into a single biological system, but between them there is also a border outpost in the form of a placenta, which protects the fetus from harmful factors. These factors may come from the mother's body, but at the same time, the mother is also protected from dangerous influences from the fetus. It is the placental barrier that makes it possible to successfully resolve most of the Rh-incompatible pregnancies.

But sometimes this barrier turns out to be faulty, in which case they penetrate through the placenta into the mother's body fetal erythrocytes. If the blood of the child and mother is incompatible with the Rh factor, then the erythrocytes of the fetus are foreign to the mother, and the body's immune system includes defensive reactions from everything foreign. Rh antibodies arise and begin to eliminate incompatible red blood cells, and this does not only occur in the mother's bloodstream. Penetrating into the blood of the fetus, they carry out their destructive work there. The result may be intrauterine damage to the fetus, and