Future parents: important about the Rh factor and the characteristics of blood groups. Rh factor. Rhesus incompatibility

About 15% of couples when planning a pregnancy may face the problem of incompatibility. If you are just thinking about a child, it is important to go through all the examinations before. The main factors of incompatibility can be the blood type and its Rh, immune response or genetic predisposition.

So, you have decided for yourself that everything will happen not “at random”, but with careful preparation so that the baby is born healthy and strong. If you don’t prepare correctly for conception and don’t check how compatible you are, otherwise problems may arise at the stage of conception of a child, bearing and after his birth.

Blood group incompatibility

Rh-conflict in future parents can only appear if the mother's blood is Rh-negative, and the father's blood is Rh-positive

During conception, the blood of the parents mixes and forms the composition of the blood of the child. The baby can have any blood type, because at the birth of the fetus, four blood groups are formed simultaneously but in different percentages. The blood of mom and dad prevails in the child's body.

If the blood type is the same for both parents, then in 95-98% of cases the baby will inherit it. When mom and dad different groups blood , then the probability that the child will get one of them is 25%. With the same success, the baby can become the owner of both I, and II, and III, and IV blood groups. In 99% of cases, the child inherits the maternal blood type and Rh factor.

It is believed that more a healthy child will be the one whose father is higher than that of the mother . For example, it will be better for the future offspring if you have I blood group, and your husband has any other, if you have group III, then it would be better for a man to have IV. Pregnancy with the same blood type is considered safe.

Rh factor incompatibility

If a couple has different Rh factors, then there is a chance that the woman's body will begin to repel the growing baby , How foreign body. But, unlike the immunological factor, with such incompatibility of partners, it is quite possible to endure and give birth to a child. The main thing is regular.

It's important to know that Rhesus conflict can only appear if the mother's blood is Rh-negative, and the father's blood is Rh-positive.

The risk increases only during childbirth, when the father's blood enters the mother's blood, and the woman's immune system begins to produce antibodies directed against the man's Rh-positive blood. But doctors have already learned to cope with such a problem.

Problems of incompatibility of Rh factors may occur during the planning of a second baby. There will be no problems with conception, but a favorable course and outcome of pregnancy are unlikely. To save it, you will need to put in a lot of effort. But! With a strong desire, everything is possible, so do not be upset in advance.

To avoid unpleasant surprises, it is better to take blood to determine the Rh factor at the planning stage of the child.

Victoria Podlesnaya, obstetrician-gynecologist: “Compatibility tests must be taken in the process of preparing for conception. Especially if your doctor has recommended it. I have patients who believe that it is not necessary to follow all the doctor's prescriptions. Sometimes a child suffers because of such decisions of future parents. I emphasize: compatibility by blood type, Rh factor and HLA must be checked before conception occurs. If you found out about the pregnancy already after the fact, take the tests anyway. They won’t take much time, but they can save the life and health of your baby.”

Genetics

As a rule, those spouses who have already passed all the others are tested for genetic compatibility. medical examinations, and in all respects are absolutely healthy. They turn to such an analysis for help when pregnancy either does not occur, or future mom can't bear the baby safely.

All cells in our body contain a protein on its surface called HLA (human leukocyte antigen). IN healthy body these proteins recognize foreign substances and send a signal to immune system to produce antibodies. They also recognize pregnancy as an alien invasion . Usually, after conception, blocking antigens are produced in the mother's body, which protect the placenta and the baby from rejection.

When Father's HLA is too similar to Mom's HLA , the body of a pregnant woman will not produce blocking antibodies. In this case, the baby and the placenta remain unprotected. If two or more HLA proteins match, then the likelihood of problems with pregnancy and child development is quite high.

Mom-forumchanka with a nickname Catalina shared her story:“My husband and I were diagnosed with genetic incompatibility. We turned out to be carriers of a hereditary metabolic disease. My daughter died at the age of one and a half months. A year later, we still decided on a second baby. Doctors immediately warned that the chances of giving birth healthy child who will live longer than our girl, a little. But we decided - and now we have a son who is already three years old. Doctors found in his analyzes signs of the same disease as in his daughter. Their forecasts are not at all bright, but our boy is alive and developing normally. And we rejoice every day, lived next to him!”.

When meeting, falling in love and creating a family, people rarely think that they have different blood types and Rh factors. The birth of a child is taken for granted, and people do not understand how lucky they are - especially if one of them has group 4, and the other has 1, and the rhesus do not match.

If pregnancy does not occur for a long time, they begin to look for the cause of this. Why nature does not notice in some cases the incompatibility of blood types of partners, while for others this becomes an obstacle to conception is not clear. However modern medicine already learned to help such families.

• Risk zone by blood group
• Reviews and comments

Signs of incompatibility of partners at conception

Exist special tests- their name is postcoital. In order to be tested, some preparation is required.

So how is the incompatibility of spouses for conception determined?

• A reliable indicator is determined if self-examination is carried out in the ovulation phase;

• It is necessary to refrain from sexual activity for 3 days;
• Before sexual intercourse, you need to wash yourself thoroughly - without the use of perfumes for intimate hygiene;
• After intercourse, you need to lie quietly on your back for about half an hour, placing a pillow under the pelvis in order to save as much seminal fluid as possible;
• You do not need to wash before a visit to the doctor - otherwise the analysis will show an incorrect result;
• After 6 hours - no later than 10 - it is necessary to pay a visit to the gynecologist.

The doctor will not do anything terrible, it will not hurt. A smear is taken on a gynecological chair, as in a routine examination.

A swab - a secret from the vagina, in which female secretions and sperm are mixed - is placed under glass and examined under a microscope.

During the study, it is necessary to determine:

• mucus crystallization rate;
• the consistency of the secret;
• acidity - the pH value of the environment;
• extensibility.

Activity - mobility - of spermatozoa is detected - it is classified according to 4 degrees:

• A - high progressive;

• B - linear and non-linear, slow;
• B - non-progressive mobility;
• D - spermatozoa are not viable.

If the identified sperm motility is grade C and D, the cervical mucus is thick and viscous, it quickly crystallizes, the environment is acidic - this means that the spouses have incompatibility during conception. For family planning in this case, you need to contact specialists for help.

Incompatibility of blood types at conception

The onset of conception is also affected by the incompatibility of the blood of partners. Although it is believed that the mismatch of Rh factors is most dangerous, blood types also matter.

The most favorable for motherhood is the blood of group 1. If the mother’s blood is also Rh positive, then to the question: “Can there be incompatibility of partners during conception?” the answer is firmly NO.

Antibodies to a foreign object are not produced, spermatozoa are not rejected, pregnancy in the future - if there are no other factors affecting its course - is normal. Whatever the group difference of the spouses, this does not interfere with conception.

If the blood of the parents matches in the Rh factor - even if the groups do not match - then even then long-awaited pregnancy maybe in due date. In this case, pregnancy also proceeds easily - the child inherits the Rh parents, no problems arise.

If, with a mismatch in groups or Rh, the fetus has maternal indicators, signs of incompatibility will not occur. Both organisms do not have agglutinin in the blood, and then the woman endures the pregnancy safely.

Incompatibility at conception is called immunological infertility. In this case, the partner's immunological cells are perceived by the female body as a foreign body and are destroyed.

A woman's blood produces antibodies that kill sperm at the stage of fusion with the egg. If conception does occur, this usually happens when, due to a decrease in the immune status, antibodies cease to be produced.

But at the embryonic stage, the body is already mobilizing all its forces to fight the "enemy", and the mother's erythrocytes, penetrating the placenta, destroy the fetal erythrocytes.

While medicine did not know how to treat incompatibility at conception, couples remained infertile, and if they managed to "deceive" nature, the long-awaited pregnancy ended in miscarriage.

For the mother's organism, this struggle did not end with the rejection of the foreign element. The woman had to recover for a long time, as the liver worked "for wear and tear", significantly increasing in size. This caused the development of anemia - anemia.

If a woman still carried a pregnancy, then the baby - all 9 months of fighting for survival - was born weak. He was diagnosed physiological jaundice that had to be treated a long period, and sometimes dropsy of the brain and even a lag in mental development, since physiological abnormalities at the embryonic stage affect the state of the brain and central nervous system.

Risk zone by blood group

Conception easily occurs if the blood type of a woman and a man are the same, or a woman - if considered in relation to the digital factor - has a lower group.

It is most difficult for a woman with the 4th blood group to get pregnant, she needs to meet a man with the same group and - preferably - with the same Rh factor.

However, blood groups still matter much less than the Rh factor, and they begin to “engage” in it only if the spouses cannot fulfill their dream of having a child for a long time.

What to do with incompatibility at conception?

You need to start planning pregnancy in advance - doctors will help you calculate best time for conception, the introduction of immunoglobulins will prepare the mother's body for the introduction of the fetus.

It may be necessary to conduct IVF - and an already formed embryo will be introduced into the mother's body, the first weeks of constantly monitoring the formation of antibodies with the help of medications.

As soon as the placenta begins to form, a chorionic biopsy should be taken. Sometimes a cordocentesis procedure is required.

Cordocentesis - blood for research is taken from the umbilical cord of the fetus, establishing its indicators, checking the molecular genetic structure, counting the number of chromosomes in the cells. This analysis helps to understand how the fetus is formed, whether there are any deviations in the development of organic systems.

Upon detection congenital anomalies, the situation - in most cases - can be corrected. Currently, blood transfusion is carried out at the prenatal stage, correcting the condition of the unborn baby and preventing developmental pathologies.

Modern medicine will help solve the problem of the family with the help of in vitro fertilization or intrauterine insemination.

If the pregnancy is long-awaited and planned in advance, you need to follow the medical recommendations and donate blood in advance to determine all the parameters, necessary for doctors to correct conception.

Blood group compatibility is a fairly relevant topic in medicine, and more specifically in the field of family planning. Having learned about pregnancy, the father and mother of the unborn child must first of all do a blood test. This basic test, which determines the group and Rh factor of the blood, plays important role in the health and well-being of mother and baby.

There are four key blood groups (types): O (I), A (II), B (III), and AB (IV). The blood type is inherited at birth and remains for life. Each of the four blood types is classified based on the presence or absence of a protein. These proteins are known as "antigens". Some of them are associated with the blood type, others are responsible for the Rh factor, which is determined by three markers (antigens): D, C and E. The most common is the "D" antigen. In Rh-positive organisms, a substance called the D-antigen is present on the surface of red blood cells. They are called RhD-positive. Rh-negative organisms do not have the "D" antigen in their blood, and such people are called RhD-negative.

The blood type has a very important purpose - it maintains the viability of the whole organism. Therefore, before planning a conception, it is necessary to check compatibility with a partner.

Antibodies are part of the body's natural defense against invading germs and bacteria. They do not recognize anything "foreign" in the body and alert the immune system to get rid of it. Human blood is grouped into four types: A, B, AB, or O. Each letter refers to the type of antigen found. For example, type A has proteins known as A antigens. Each blood type has its own Rh factor (Rh) - positive (Rh+) or negative (Rh−). Worldwide, the most common blood types are O+ and A+. About 85% of the population has Rh +, the remaining 15% - owners of "Rh-"

Rh factor is 50 types of different proteins, if at least one is present, then Rh is considered positive. The child inherits the blood type and Rh factor from the parents. During pregnancy and childbirth, RhD plays an important role when an RhD-negative mother is expecting an RhD-positive baby. This only happens when the child's father is an Rh positive carrier. However, not all babies with an RhD+ father get a positive Rh factor.

Studies over the past 40 years have shown that infertility and habitual miscarriage may be the result of antibodies in the woman's vaginal secretions reacting with blood antigens in the male semen.

The problem of incompatibility

The Rh factor is checked by a blood test. "Rh−" poses a threat to a woman in labor if her Rh does not match the Rh of the child. Research has shown that some problems are related to blood type incompatibility between mother and fetus or between parents. As described above, markers (antigens) protect the body from external pests such as bacteria and viruses. When an antigen encounters a foreign object, it creates antibodies against it. The same thing can happen when trying to get pregnant. The body will respond by producing antibodies to the appearance of sperm or fetus, which will prevent conception.

The problem occurs when the Rh of the mother's blood does not match the Rh of the fetus, and the body begins to produce antibodies against proteins on the baby's red blood cells. An Rh-negative woman in labor does not always pose a threat to the development of the fetus:

• if both parents are Rh-negative, and the child also receives "Rh-", then there are no complications;
• if the mother has "Rh−", and the father has "Rh+", and the fetus receives a negative Rh, then there is no threat of conflict;
• if the woman in labor has “Rh +”, and the child has a negative Rh, protein incompatibility will not occur.

The chance of the child inheriting Rh and the probability of conflict in the table.

Rh factor

How does the Rh factor affect pregnancy

Rh problems occur when the mother is Rh negative and the baby is Rh positive. This is called Rh incompatibility. As a rule, such conflicts do not arise during the first pregnancy, but will be possible with next conceptions. If the "Rh+" blood of the fetus is mixed with the negative Rh of the mother during pregnancy or childbirth, then the blood of the woman in labor will begin to create antibodies against "Rh +", as if it encounters harmful substances.

Rh antibodies can cross the placenta and attack the baby's blood. Such actions lead to hemolytic anemia, which destroys red blood cells. In this case, the amount of bilirubin in the blood of the child increases. After birth, the baby has a low muscle tone, lethargy and yellowness of the skin and whites of the eyes. Red blood cells are responsible for the presence of oxygen in all parts of the body. If there are not enough red blood cells, the child's body is not enriched the right amount oxygen, and hemolytic anemia can lead to serious illnesses as well as fetal death.

When a woman is carrying a baby, the placenta acts as a barrier between the red blood cells of the mother and the child. There are times when small portions of the baby's blood can enter the blood of the woman in labor:

• most often it happens during childbirth;
• the risk of blood mixing occurs during a miscarriage or during an abortion;
• in situations accompanying pregnancy - as amniocentesis (sampling of chorionic villi);
• with vaginal bleeding or abdominal trauma.

If the expectant mother has a negative Rh, and the partner has a positive Rh, then female body may reject the fetus. interfere this phenomenon only experts can.

How to avoid problems

If incompatibility is detected, the doctor arranges several blood tests for the still pregnant woman to control the level of antibodies. After birth, the baby's blood is also tested. If the baby is "Rh+", then the mother is offered an injection of anti-D (immunoglobulin) within a few days after birth. Anti-D prophylaxis is taking a drug that prevents a woman's body from producing antibodies against Rh+ cells. Today, Rh sensitization during pregnancy and after childbirth can be largely prevented. For this purpose, prophylaxis is carried out with the help of anti-D-immunoglobulin.

All Rh-negative expectant mothers are offered injections of anti-D-immunoglobulin. This procedure prevents harm from Rh incompatibility..

In general, all pregnant women who are Rh-negative and do not have antibodies to the D antigen are recommended prophylaxis with anti-D-immunoglobulin. This is either one injection between 28-30 weeks of pregnancy, or two - at 28-34 weeks. Such prevention is called current prenatal (antenatal).

The process by which the mother begins to produce antibodies against the D antigen is called potentially sensitizing. Sometimes, after the occurrence of such circumstances, additional injections of anti-D-immunoglobulin are needed. Such situations include the following:

• threatened miscarriage or miscarriage;
• ectopic (ectopic) pregnancy;
• abortion;
• vaginal bleeding;
• obstetric intervention;
• trauma to the abdomen, for example, after a fall or a car accident.

Every event, whether it is vaginal bleeding or abdominal trauma, should be reported to the midwife or attending physician as soon as possible by the woman in labor.

Timely consultation with the attending physician is the right move to trouble-free bearing and to the birth of a healthy baby.

What is anti-D

Anti-D-immunoglobulin is produced from a component of donors' blood called plasma. In this case, as with any other medicines made from blood, there is a possibility of transmission of the virus from the donor to the recipient of anti-D-immunoglobulin. However, all donors are carefully screened, and the manufacturing process involves virus removal and destruction to minimize the chance of transmission.

The latest methods of research, treatment and prevention lead to complete control over the pregnancy process, minimizing the risks of complications in case of blood incompatibility. Timely delivery of tests, as well as an appeal to the attending physician, will help prevent the occurrence of any conflict situations.

Video - Pregnancy and Rh blood factor

When planning a pregnancy, future parents are advised to take tests in advance to determine their blood groups and Rh factor, in order to avoid possible conflict and complications during conception. Even if they didn’t, then as soon as the expectant mother comes to the first appointment in women's consultation, she will still be sent to do a lot of tests. And one of them will be the determination of the group and Rh affiliation of the blood of partners.

A child can become the owner of any of the blood groups, since four groups are formed simultaneously at conception. The largest percentage is the blood of the parents. If the parents have the same group, then, in almost all cases, the baby will have the same group.

Details on the inheritance of blood types of a child from parents:

The main thing about the Rh factor. What is the "Rhesus conflict" in partners and its effect on the fetus

Gynecologists are sure that the influence of the blood group on conception is not so important as the Rh factor of the parents. It is desirable that future parents have the same entry in the cards in the "Rh factor" column, this will help to avoid problems that, otherwise, may arise both during conception and during pregnancy and even after the birth of the baby.

Therefore, if it became known in advance that the values ​​​​of the Rh factor of the partners do not match, then before conception it is desirable, and sometimes simply necessary, to undergo special therapy in order to prevent the rejection of the fetus by the mother's body.

If, nevertheless, couples with different Rh factors are already expecting a baby, and no preventive measures were taken at the stage of pregnancy planning, then you need to carefully monitor the condition of the fetus throughout the pregnancy. To date, at timely diagnosis Rhesus conflict can be neutralized by introducing anti-Rh immunoglobulin for a period of 26-27 weeks.

Rhesus conflict in mother and fetus. What is the danger?

There will be nothing terrible if a pregnant woman has a negative one, and a child has a negative one. This should not worry parents. But if the opposite is true: the mother has a negative Rh factor, and the child has a positive one, then it is likely that the Rh conflict will still arise.

Fetal erythrocytes, when released into the mother's blood, can be perceived by her body as foreign bodies, which will provoke an immune response. Therefore, it is so important to monitor the level of Rh antibodies in the expectant mother. Until the 28th week, the Rh factor should be tested monthly, after this period - every two weeks. Doctors also Special attention turn to the fetal liver: if it is enlarged, it may be necessary to do an intrauterine transfusion or even terminate the pregnancy.

Therefore, if we talk about the conception of a child, then most future parents, as a rule, are concerned about the influence of the Rh factor. But very few people know about the threats that the incompatibility of the blood types of the mother and the unborn child can carry.

Reasons for incompatibility

As you know, type I blood is characterized by the fact that its erythrocytes lack antigens A and B, but they have antibodies? And?. At the same time, the remaining groups have such antigens, in connection with which the first group, when it encounters antigens A or B alien to its environment, enters into a fight against them or, the so-called conflict, as a result, erythrocytes containing antigens are destroyed.

This conflict is just called the immunological conflict according to the AB0 system, or more often it is called the "blood type conflict".

Compatibility of blood types of husband and wife when conceiving a child:

Who is at risk?

A blood type conflict becomes likely when a pregnant woman and an unborn child have different blood groups (Table 1):

• In mother I or III - in child II;
• In mother I or II - in child III;
• In mother I, II or III - in a child IV.

Women with type I blood who are carrying babies of groups II or III are most at risk. This combination most often provokes a conflict in the blood type of the mother and her baby, which can cause. Doctors also pay special attention to such combinations of blood groups in partners (Table 2):

• Women of the I blood group - men II, III or IV;
• Women of group II - men of III or IV;
• Women of group III - men of groups II or IV.

What influences the conflict and its development?

If the pregnancy goes well, then such a conflict is excluded. Mainly thanks to the placenta: placental barrier prevents the blood of mother and child from mixing. But if this happens, then there is a risk of hemolytic disease in a baby, because of which the organs of the child often suffer, especially the brain, kidneys, liver.

How to identify incompatibility, methods of treatment and prevention

Regular analysis may show incompatibility of groups. Incompatibility will be indicated by the presence high level antibodies in the blood of a pregnant woman.

Group conflict in a newborn is manifested when observing such symptoms: anemia, edema, jaundice, enlarged spleen and liver. Conflict or incompatibility is always necessary to visit a doctor and be aware of your situation.

In order to prevent dangerous consequences, to which incompatibility of blood groups can lead, it is recommended to take a blood test for hemolysins (specific antibodies) frequently. If available, the expectant mother should be in the hospital under close attention doctors.