Rh-conflict during pregnancy The overwhelming majority of people (about 85%) have Rh-positive blood. This means that it contains the Rh factor protein, which is located on the surface of red blood cells. As a rule, during the first pregnancy of a Rh-negative mother with an Rh-positive fetus, conflict occurs relatively rarely. The more births or abortions preceded the current pregnancy, the greater the risk of developing Rh-conflict. The consequence of the Rh-conflict is a serious congenital disease - hemolytic disease of the newborn (HDN). The mother's body "considers" the baby's blood as a foreign substance and begins to produce antibodies, attacking the baby's blood cells. With a conflict of rhesus during pregnancy, the fetus may experience anemia, jaundice, reticulocytosis, erythroblastosis. Rh-affiliation of the fetus is formed at the earliest stages of pregnancy. Incompatibility can develop if the Rh-negative mother carries a positive one.

Blood group and Rh factor incompatibility. Pregnancy and rhesus-conflict - questions to genetics, gynecologist.

The main blood components that affect the course of pregnancy are blood type and Rh factor (Rh). At the stage of conception, the incompatibility of the blood group and the Rh factor does not manifest itself in any way. But, problems may arise during pregnancy. This is already influenced by the compatibility of the blood of dad and mom. Therefore, young spouses should remember: if a woman has Rh-negative blood, her first pregnancy should end with the birth of a child. Group incompatibility of the blood of the mother and the fetus develops if the mother has group 0 (I), and the fetus has A (II), B (III) or AB (IV). Fetal antigens A and B can enter the mother's bloodstream during pregnancy, leading to the production of immune α- or β-antibodies. As for the concept of incompatibility of blood groups during pregnancy, this is a very rare occurrence. More often there is a conflict due to the Rh factor. At the same time, it is necessary to clearly understand that the incompatibility of partners may be of a genetic nature, and may also be associated with differences in the blood group of future parents.

Can my child have a negative Rh (blood group 2), if my husband and I have a blood type 2, Rh positive? Or was there an error in someone's analysis?

The male and female germ cells contain 23 pairs of chromosomes, which carry the genes responsible for the formation of the child. Among them there are genes responsible for its Rh factor. This can be. A person with a positive Rh factor can be a carrier of a negative rhesus gene (this gene is suppressed by the gene of positive rhesus, so when both genes are present - rhesus positive, but negative can be passed on to the child). In this case, both parents are Rhesus negative carriers, both passed it on to the child, and as a result he has a negative Rh factor.

I have a second blood group and a negative rhesus. What problems can I face during pregnancy and during childbirth?

Unfortunately, you do not write about what blood type your husband has, whether you have had any previous pregnancy.

You may have problems during pregnancy if your husband has a blood type 3 or 4, and the Rh factor is positive.

Then, if the child inherits the blood type or Rhesus of the father (and this is not 100%), then antibodies directed against this "foreign" group or rhesus may form in your blood. During the first pregnancy with an Rh-positive fetus, they are only formed and rarely work. During the second pregnancy (not in general, namely the second pregnancy with an Rh-positive fetus), these antibodies can work against the child and cause complications of pregnancy up to its termination and hemolytic disease of the newborn. In order to prevent possible unpleasant consequences in time, you must first find out the cut group and Rh of the husband, and if there is reason for concern, starting from the 7th week of pregnancy, to determine antibodies to the Rh factor and to the antigens of the blood group in the blood. If they appear, the attending physician will prescribe drugs that block their action. These conditions are treated if they are known in advance.

Can Rh-Positive Parents Have a Rh-Negative Baby? The fact is that I was diagnosed with the 4th blood group (Rh negative), and my father and mother have a positive Rh. Is there a mistake in the analysis?

Maybe I won't go into the intricacies of solving genetic problems. I am sending you a table of possible variants of Rh factors in children with appropriate parents.

Recently, they often talk about combining blood in opposite sexes during the conception of a fetus. My blood type is A 2 (+), and my fiance is 3 (-). How can this affect the health of the unborn child?

You can read the article "Blood Conflict" on our website. It describes in some detail what can be expected with different blood types of partners and tables are given in which the possible variants of the blood type and Rh factor in a child are given and the likelihood of a conflict developing.

I have such a question, a positive result is possible, i.e. a healthy child, if a woman has a negative rhesus and had a termination of pregnancy, and after a board she did not take anything in order to kill the anti body. Is it possible for such a woman to have children with a man with a positive Rh factor? Is it possible to prophylactically before conceiving the next fetus?

Yes, but it is necessary to prevent the development of Rh-conflict by introducing anti-Rh antibodies.

Why does the blood type of the child not match the blood type of any of the parents?

each trait of an organism is encoded by a pair of genes. This pair in a child is made up of one gene from each of the parents. The combination of genes can give a trait different from the trait of the parents.

Question: my wife has blood group 0 (1) +, I have B (3) - what is our probability of Rh-conflict during conception?

The fact is that in the presence of a positive Rh factor in a woman, a conflict on this basis is excluded. A child can inherit both the Rh factor of the father and the mother (50 to 50%). The likelihood of a conflict by blood type is 50%, but a conflict by blood type is extremely rare.

My parents are Rh positive, blood groups 2 and 3. I have 1 group Rh negative. I read that this can be 1% out of 100. I gave birth to a child with negative rhesus in group 2. Tell me, what threatens me with a second pregnancy if the child is Rh positive? It somehow affects my body that my parents are Rh positive, and I am negative. And why my mother didn't have Rh-conflict. If possible, then explain everything in more detail.

If a woman with Rh negative blood is pregnant with a fetus that inherits Rh positive blood from her father. When the blood of the mother and the fetus is in contact, the mother's body perceives the fetus as something foreign and produces substances (antibodies) that contribute to its rejection. This can hinder the normal growth and development of the fetus, have a detrimental effect on the health of the unborn baby.
When a woman with Rh-negative blood is born, a child with Rh-negative blood will not have a conflict, since "harmful" antibodies are not produced. During the first pregnancy, a conflict due to the incompatibility of the blood of the mother and the fetus in terms of blood group and Rh factor rarely develops, because there are not enough antibodies yet. During the first pregnancy, a conflict due to the incompatibility of the blood of the mother and the fetus in terms of blood group and Rh factor rarely develops, because there are not enough antibodies yet. The same happens with a repeated pregnancy with a Rh-positive fetus, provided that the previous child had a negative Rh. Often antibodies (AT) are formed even before pregnancy as a result of previous blood transfusions without taking into account Rh compatibility, spontaneous or induced abortions, ectopic pregnancy. Various complications of the course of pregnancy (toxicosis, increased blood pressure, threat of termination, infectious and internal diseases of the mother) aggravate the severity of the condition and increase the likelihood of conflict development. Women who are at risk of developing conflict should be closely monitored by an obstetrician-gynecologist during pregnancy. Throughout pregnancy, it is necessary to determine the level of Rh antibodies in the blood (once a month up to 32 weeks of pregnancy, 2 times a month from 32 to 35 weeks, and then weekly). The height of the antibody titer helps to predict the severity of the condition of the fetus and newborn and, if necessary, take measures to prevent the development of complications.
It is possible to prevent the development of a conflict during repeated pregnancies by introducing an anti-Rh immunoglobulin immediately after the first childbirth, with termination of pregnancy in women with negative Rh, with transfusion of incompatible blood. Usually this is part of the routine practice of maternity hospitals, but when choosing an institution where you are going to give birth, it is better to ask this question.

I am interested in the problem of the consequences of abortion in case of Rh conflict between mother and child. The fact that repeated pregnancy is associated with a risk to the health of the child, I know what the risk is too. Information about the drug (in injections), which is administered immediately after an abortion, or after childbirth with Rh conflict, slipped past me, which minimizes the risk of subsequent pregnancies. Could you name this drug, explain its effect and answer the question: can it be used some time after an abortion.

You are right, there is such a drug - anti-rhesus immunoglobulin, which forms non-pathogenic immune complexes with antibodies against erythrocytes and is eliminated from the body. The drug is administered in the first 4 hours after childbirth or abortion. If anti-Rh (D) antibodies have not been administered prophylactically, then they must be administered during pregnancy.

My wife has the following situation: Her parents have a father's blood group 3+, a mother has 2+, she has a 2+ blood group since birth. At the moment she is 22 years old and until now everything has been fine. She became pregnant, at the hospital they sent me to be tested for the group and rhesus. After the express analysis, they said that 2+ and after a full expanded 2-. Practically every month they did analyzes and in all cases it turns out express 2+ and scan 2-. How can this be? And in general, are there such situations?

My husband and I have positive Rh factors, and my husband's blood groups are B (3), and I have A (2). In one magazine we read the article "The fewer antibodies, the better." We have one child, but we want two more. Based on this article, we want to ask: Is there a conflict caused by an incompatibility in the blood group of the mother and the fetus? Is it related or not related to the Rh-conflict? When does it occur and how to avoid it? If it is nevertheless inevitable, then what are the consequences (deviations) of the child because of him? How to determine the presence of an ABO conflict in a pregnant woman, where and what tests should be taken? And yet how to avoid it (if it is, of course)?

The incompatibility of the blood of the mother and the fetus can be not only for the Rh factor, but also for blood groups. Most often, blood group incompatibility occurs when the mother has the first, and the fetus has the second or third blood group. The manifestations of this conflict in the fetus and the newborn are such as in the Rh-conflict. To diagnose the disease, it is necessary to determine the level of anti-erythrocyte antibodies in the mother's blood with the same regularity as the level of anti-rhesus antibodies. If abnormalities are detected, desensitizing treatment should be carried out.

Will a positive Rh factor in the mother and negative in the father affect the health of the unborn child? And will the pregnancy proceed normally?

In this situation, there will be no Rh-conflict, so the difference between the Rh factors of the mother and the father will in no way affect the health of the child and the course of pregnancy.

My sister and her husband have the 1st blood group (Rh factor +), and their daughter also has the 1st, but the Rh factor is. Could this be? And what is the reason?

Answer: a person's blood group and Rh-affiliation are determined by his heredity. Each trait is encoded by a pair of genes. Signs are dominant (they always appear, even if one gene is recessive and the other is dominant) and recessive (they appear only if each gene from a pair is recessive). Rh positive is the dominant sign. Apparently, in each of your niece's parents, the sign of a positive rhesus is coded so that one of the genes is dominant - "+", and the other is recessive "-". This is why they are Rh positive. And their daughter got a recessive gene from each of them.

My wife has the first blood group, I have the third. Both have a positive Rh factor. Our son has the first blood group and is Rh positive. The daughter, who was born quite recently, has a third blood group, but a negative Rh factor. Both my parents and my wife's parents have Rh-positive blood. How can this situation be explained, because the Rh factor is a hereditary trait?

I will not devote you to the intricacies of science - genetics, I will just give you a table of possible child blood groups when combining your blood groups with your spouse. Let me just say that even if your parents are Rh positive, and you and your spouse are also Rh positive, there is a 50% chance that you have a negative Rh factor gene in your genetic makeup.
Rh factor - father +, mother +, child 75% +, 25% -
Blood groups father B (111), mother 0 (1), child 0 (1) or B (111)

Wife blood group 1 - husband 3+ can have problems in the 2nd pregnancy. if 1 pregnancy was interrupted

I have the 1st blood group Rh negative, my husband has the 3rd positive, I have herpes on the DNA and I had the 1st undeveloped pregnancy. Can there be complications for me and the child during the second pregnancy after the treatment of herpes?

Due to the difference in blood type and Rh factor between you and your husband, an immune conflict may arise during a repeated pregnancy if the fetus has your husband's blood type and / or Rh factor. The introduction of anti-Rhesus immunoglobulin during termination of pregnancy reduces the risk of complications during the subsequent one. Throughout pregnancy, it is necessary to determine the titer of Rh antibodies in the blood (once a month up to 32 weeks, 2 times a month from 32 to 35 weeks, and then weekly).
The herpes virus enters the human body mainly in childhood and adolescence (90% of the population), where it is inactive. With unfavorable environmental factors and / or weakening of the body, it is activated and manifests itself with various clinical symptoms. Treatment cannot destroy the virus, but it puts it back into a "dormant" state that does not interfere with the course of pregnancy, the development of the fetus and the newborn. However, during pregnancy, it is necessary to constantly monitor the level of antibodies to the herpes virus in the blood. Therefore, you should be closely monitored by your doctor throughout the pregnancy.

I have II blood group, Rh factor is positive, my husband has I and Rh factor is negative. can this fact cause any complications during conception and further pregnancy?

Conflict on the Rh factor and blood group, which arises with their different values ​​in the mother and the fetus, does not threaten you. It develops if the mother has Rh-negative blood, and the fetus has positive blood; and it is extremely rare if the mother has the first blood group, and the fetus has the second. Your situation is completely opposite. And no matter what rhesus (positive or negative) and blood group (second or first) was, your baby should not have any problems.

I have a question about Rh-conflict. My girlfriend is Rh negative, blood type is IV (-), and I have II (+). She has a child from her first marriage, and also had an abortion in her first marriage. I read that we may not have common children because of the Rh-conflict and that abortion. How likely is it to have a common and healthy child?

Before the planned pregnancy, a woman with Rh (-) blood needs to donate blood to determine the titer of anti-rhesus antibodies, if necessary, the blood is "purified" from these immunoglobulins, and then during pregnancy the level of these antibodies is dynamically monitored.

Hello! I want to ask a question. I have a negative Rh factor, my husband has a positive one. Now I am expecting my second child, the term is 25 weeks (the first girl is 4 years old). So far, no Rh antibodies have been detected in the blood. What is the likelihood of their appearance, how is it dangerous and how they can affect the further course of pregnancy. Thanks.

The likelihood of developing Rh-conflict with each pregnancy is 10%. In Rh-conflict, antibodies, penetrating the placenta to the fetus, cause the destruction of its blood - hemolysis. Oxygen deficiency of the fetus and its poisoning with blood decomposition products develop. Therefore, when the fetus develops antibodies to the Rh-conflict, the woman is immediately sent for treatment to a special institution.

I have a negative rhesus. There were 2 early abortions and a cesarean section 4 years ago. There were no antibodies during pregnancy. Immunoglobulin was not administered. What are my chances of having my second child healthy and what can be done to achieve this before pregnancy?

The risk of developing sensitization with each pregnancy is ~ 10% (with Rh-conflict). The first two abortions did not cause you sensitization (lucky). During the third pregnancy, sensitization also did not develop. There is a risk that antibodies may have developed during the caesarean section, when there is a massive exchange of blood flow between the mother and the fetus. If the baby is born Rh negative, then during the next pregnancy, it is necessary to regularly monitor the presence of antibodies to the Rh factor. If the baby is Rh-positive, then the check for antibodies to the Rh factor should be started before pregnancy.

My daughter has a blood group 2, Rh-negative. I am worried as for a future mother. How long can she give birth to children, have abortions?
Each pregnancy and abortion increases the likelihood (risk) of Rh sensitization by 10%. Therefore, it is better for women with negative rhesus not to have abortions at all. After the end of pregnancy, anti-Rh immunoglobulin should be administered. If these rules are followed, a Rh negative woman can have as many children as she wants.

I have the 1st blood group Rh negative, my husband has the 3rd positive, I had herpes by DNA and had the 1st pregnancy that did not develop. Can there be complications for me and for the child during the second pregnancy after the treatment of herpes.

Due to the difference in blood type and Rh factor between you and your husband, an immune conflict may arise during a repeated pregnancy if the fetus has your husband's blood type and / or Rh factor. The introduction of anti-Rhesus immunoglobulin during termination of pregnancy reduces the risk of complications during the subsequent one. Throughout pregnancy, it is necessary to determine the titer of Rh antibodies in the blood (once a month up to 32 weeks, 2 times a month from 32 to 35 weeks, and then weekly).
The herpes virus enters the human body mainly in childhood and adolescence (90% of the population), where it is inactive. With unfavorable environmental factors and / or weakening of the body, it is activated and manifests itself with various clinical symptoms. Treatment cannot destroy the virus, but it puts it back into a "dormant" state that does not interfere with the course of pregnancy, the development of the fetus and the newborn. However, during pregnancy, it is necessary to constantly monitor the level of antibodies to the herpes virus in the blood. Therefore, you should be closely monitored by your healthcare provider throughout your pregnancy.

Hello! My wife has a blood type I and is Rh negative, and her gynecologist said there was practically no chance of getting pregnant. Even if this happens, there will be a very difficult delivery. Is it so?

Blood type and Rh factor are not associated with the possibility of getting pregnant. This does not have any effect on generic activity. Your spouse has a chance of developing an immunological conflict during pregnancy (if the child has Rh "+" or a different blood group). But the risk of this problem does not exceed 10%. We recommend that you talk to the gynecologist again. Apparently, you did not understand each other.

Is there a method for predicting a child's blood group and Rh factor based on the same indicators of parents? Should a parent's blood be suitable for direct transfusion to their child?

People have a lot of blood groups - the ABO system, Rhesus, Kell, Duffy, Kidd, Lewis, Lutheran, etc. Due to the huge number of combinations, each person is unique in terms of a set of different blood group systems. In practical medicine, usually only 2 systems are taken into account: ABO - according to which people belong to 1 (O), P (A), W (B) and 1U (AB) groups, the Rh factor - among Europeans, about 15% Rh " - "negative and 85% Rh" + "people. Blood groups are inherited according to well-defined genetic laws, which are quite complex. Even if the parents' blood groups are the same, the child may have a different one (for example, a Rh "+" parent may have a Rh "-" child. If the father is O (1) group and the mother is AB (1U), then the child will be either A (P ), or B (W) groups, etc.) It often happens that the blood of the parents (one or both) does not find a child for transfusion. Methods for predicting blood groups, Rh factor and other blood systems of a child have existed for a long time, but they can only predict the likelihood of having a child with one or another group. (With Rh "+" European parents, the probability of having a child with Rh "-" blood and with Rh "+" 97.75% With Rh "-" parents, the probability of having a Rh + "child is practically equal to 0.

Not so long ago, Rh-negative blood during pregnancy was a serious threat to its course. Doctors predicted a future mother, especially if she is pregnant with a second or third child, a whole range of negative consequences for the baby. If a woman, having a negative Rh factor, for some reason decided to artificially interrupt the bearing of a fetus, an abortion could cause further childlessness.

Today the situation has changed dramatically. Modern diagnostic and therapeutic methods allow minimizing the risks of negative indicators of this parameter in the mother.

What is Rh factor?

In the composition of the blood of humans and animals, red blood cells are present, on the surface of which there is an antigen or protein called the Rh factor. This is a constant indicator and it cannot change during life. Sometimes there is evidence that after medical manipulations in a person, this blood parameter changes. But it has been scientifically proven that its change is impossible. The answer to the question why such information appears is the erroneous results of determining the presence of an antigen before or after medical manipulation.

If a person's erythrocytes have this antigen, the Rh factor is called positive, if not, negative. More than 85% of the world's population is rhesus positive. Information about whether a person has an antigen or not is necessary for blood transfusion, emergency medical care, and surgical intervention. These parameters are sometimes used to determine the sex of the unborn child, but there is no data to confirm the accuracy of such techniques.

It is reliably known that the detection of a negative Rh factor du in a patient means that, if necessary, he is given a blood transfusion only with a negative indicator.

During pregnancy, the Rh factor is very important. If the mother is negative and the husband is positive, the baby can inherit the paternal antigen. This is fraught with the development of the Rh-conflict, with which the mother's body will fight with the active production of antibodies, perceiving the growing baby as a foreign body. If you do not take action, the course of such a pregnancy will end negatively.

The compatibility of Rh factors and blood groups with each other is determined according to a special table.

(Table drawing)

When both spouses have the same Rh positive or negative factor, they have nothing to worry about. It is necessary to take measures while carrying a baby only with different values ​​of this indicator in young parents.

Features of pregnancy with negative rhesus

If the parents have different antigen indicators, and there is a likelihood of Rh-conflict when carrying a fetus, this is not a reason for a disorder. Sensitive supervision of specialists and regular testing, as well as knowledge of how to give birth with a negative Rh, will help to pass this stage without risks for the child.

During the first pregnancy

It is only during pregnancy that a woman first encounters unfamiliar, foreign antigens. It is highly likely that the production of antibodies against antigens will not start at all. In the first pregnancy, the process of their production (if it has begun) is slow. A decrease in immunity, due to a change in the hormonal background and the slowness of white blood cells, contribute to the fact that the Rh conflict either does not begin at all, or is poorly expressed.

During the second and subsequent pregnancies

Faced with foreign antigens, the body acquires "cellular memory". This means that the next collision with a foreign antigen, the formation of antibodies in the female body will occur much faster. With each subsequent time, the speed of the process increases, increasing the inevitability of the development of the Rh-conflict.

Memorization occurs not only after the successful bearing of a baby, but also after a miscarriage, abortion, medical intervention associated with blood transfusion.

If the Rh-conflict in the body of a young mother has developed, modern medical methods are able to correct the situation in time. She is recommended to be constantly under the supervision of specialists.

Consequences of a negative Rh factor during pregnancy

A pregnant woman with a negative rhesus is required to be tested for antibodies on a monthly basis. The obstetrician-gynecologist pays close attention to the accompaniment of pregnancy with such an anamnesis. Until the thirty-second week, the analysis of venous blood for the presence of antibodies is carried out every month. After the thirty-second week, it should be taken every couple of weeks. From week 35 - weekly.

For the rest, carrying a baby by a mom with a negative Rh does not differ from the course of a normal pregnancy. The rapidity of the development of antibodies depends on whether it will be necessary to inject the immunoglobulin of the expectant mother.

Influence on baby's health

If preventive measures are not taken, dangerous pathological processes are triggered:

1. A decrease in the number of red blood cells in the fetus, which are responsible for transporting oxygen, from which oxygen starvation gradually develops. First of all, it affects the development of the heart and brain.
2. The amount of bilirubin increases. It is produced by the destruction of red blood cells. The increasing amount of bilirubin causes serious fetal toxicity.
3. Strengthening the production of red blood cells by the spleen and the child's liver, causing an increase in these organs and their pathological development.
4. The development of an imbalance in the blood, impaired production of blood particles, the development of pathologies in the development of the spinal cord, congenital hemolytic anemia.Hemolytic disease of the newborn (HDN) is manifested by pallor of the skin, general weakness.

Methods for diagnosing problems with a negative Rh factor during pregnancy

The presence of antibodies in a young mother is determined at the very beginning of gestation. Many women know about their rhesus long before conception and the onset of an "interesting situation." The obstetrician-gynecologist puts such a mom on a special record. Having revealed a negative result of the antibody test, the doctor prescribes monthly venous blood donation to the expectant mother to control the rate of antibody formation. The closer the due date, the more often a young mother has to be tested in order to control the situation.

In addition to the blood test of the pregnant woman, scheduled ultrasound examinations are prescribed, in which close attention is paid to the state of the baby's liver and spleen, as well as to the state of the placenta.

If any pathologies are detected, cardiotocography (CTG) is additionally performed, as well as dopplerometry. These studies make it possible to assess the functioning of the child's cardiovascular system, as well as whether a sufficient amount of oxygen is supplied to him through the uteroplacental bloodstream.

If the analysis of anti-rhesus bodies shows their rapid growth, invasive diagnostic methods are used. This method of diagnosis is dangerous due to the leakage of waters surrounding the fetus, the risk of infection, the formation of a hematoma on the umbilical cord.

Analysis of amniotic fluid is the most reliable study, which indicates the exact amount of bilirubin produced by the baby, which makes it possible to assess the condition of the fetus. The sampling of material from the umbilical cord also provides reliable information about the composition of the fetal blood.

Specificity of childbirth

If the incompatibility of the Rh factors did not lead to the rapid formation of antibodies and the pregnancy proceeded normally, without pathologies, the baby may be born naturally. In the process of delivery, the production of antibodies in the mother's body may be activated in connection with the loss of some amount of blood. To do this, in the delivery room, the obstetrician-gynecologist should have at hand a portion of blood of the same group and rhesus as the woman in labor. To eliminate the risk of pathologies during the birth process, an injection of immunoglobulin is allowed to a woman in labor.

In cases where the child has inherited not the maternal Rh, but men, and when the baby is bearing the Rh conflict, a decision is made to deliver by cesarean section. A problem pregnancy is maintained and maintained up to 37-38 weeks, and upon reaching this period, a planned operation is performed.

In difficult situations, a newborn baby is given a blood transfusion of the same group and rhesus as that of the mother. In the first days, a newborn is fed not with breast milk, but with mixtures. This is due to the fact that breast milk still contains antibodies. If they enter the baby's body, they will begin to destroy the red blood cells of his blood.

A young mother is injected with immunoglobulin within 72 hours after giving birth. This will prevent the development of conflict in subsequent pregnancies. The same measures should be taken after an abortion or miscarriage. It is extremely important to keep within three days with the injection.

Even if the first birth and the period of gestation passed without complications and the woman plans the next pregnancy from a man with a positive Rh, her body will still develop memory cells, therefore, for the next birth, the drug for injection will either need to be purchased independently, or its presence in the maternity ward. home.

More information about what Rh-conflict is, how it is bad, and how pregnancy proceeds with such an anamnesis, can be found in the video:

Conclusion

A negative rhesus in the mother is not a reason to abandon motherhood, and the incompatibility of rhesus with a beloved man is not a reason to part with him. In the vast majority of cases, bearing a baby under this circumstance proceeds without pathologies. Rh-conflict occurs only in ten percent of pregnant women. Serious developmental and health problems are noted in only two or three out of a thousand babies.

Every woman with a negative Rh factor knows that this circumstance can affect both conception and the course of her pregnancy in the future. But not everyone knows who is at risk and how the development of immunological incompatibility between mother and fetus can be prevented.

Rhesus factor Is an antigen found in human erythrocytes. If it is, its carrier is a Rh-positive person, and if not, a Rh-negative person. There are only about 15% of such people. This antigen got its name from the name of the rhesus monkeys, in which it was first discovered. In the erythrocytes of the fetus, the Rh factor appears at about the eighth week of pregnancy. When a Rh-negative woman becomes pregnant from a Rh-negative man, then they can only have a Rh-negative child, and in this case there will be no immunological incompatibility. Trouble can begin only when an Rh-negative woman carries a child under her heart from a man with a positive Rh factor. Why? A special protein, which is present in the child's blood and is absent in the mother's blood, begins to penetrate into the woman's body during pregnancy. Her body regards it as a foreign object and develops protective antibodies against it. When these antibodies enter the baby's blood, they begin to destroy the fetal blood cells. When red blood cells break down, they release a substance called bilirubin. In large quantities, it can adversely affect the health of the child.

If a woman has this first pregnancy and before that there were no miscarriages, no abortions, no blood transfusions, then the likelihood that there will be a Rh-conflict is rather small. Otherwise, the body of a Rh-negative woman has already developed antibodies to a foreign protein, as if "remembered" them. And in case of pregnancy, he will begin to reject the fetus. If the pregnancy can be maintained, there is a risk of developing hemolytic disease in the child.

When the expectant mother comes to register for pregnancy at the antenatal clinic, her blood is immediately taken to determine the Rh factor. If it is positive, then the Rh-conflict does not threaten her. The situation changes if Rh is negative. Then the blood of the future father is also taken for analysis.

If both parents have negative Rh factors, their child will also inherit this trait, and the pregnancy will proceed as usual. The attention of doctors is demanded by the situation when mom is with a "minus", and dad is "with a plus." The expectant mother with a negative Rh factor will be tested for the presence of antibodies to the Rh factor of the child throughout the pregnancy.

Up to 32 weeks - every month

At 32-35 weeks - once a week

From the 35th week - weekly

If antibodies are detected at any time, the woman is hospitalized in a hospital. If there is an increase in titer or the so-called "jumping titer", the procedure of amniocentesis is necessarily performed - puncture of the fetal bladder to study the amniotic fluid to determine the level of bilirubin in them. If it is quite high, your doctor may prescribe one of the following procedures.

Plasmapheresis. Plasma is taken from the woman, purified, and then poured back. This method is the least effective, but the simplest.

Blood transfusion to the fetus... It is believed to be the most effective way to deal with Rh-conflict. Its tangible disadvantage is that such a procedure is performed only in large medical centers in Moscow and St. Petersburg. The principle is as follows: under ultrasound control, substances that relax the fetal muscles are injected into the umbilical vein, and then blood with an Rh-negative indicator is injected through a needle. Rh-negative donor red blood cells are not destroyed by maternal antibodies. Repeat the transfusion two to three weeks later. In fact, donated blood temporarily replaces the fetus's own blood. If such a procedure does not help, the question arises of pre-term birth. Therefore, doctors are trying with all their might to hold out a Rh-conflict pregnancy at least up to 34 weeks, because by this time the baby's lungs have already formed enough so that he can breathe on his own.

Women's concern about negative Rh factor during pregnancy is justified.

Indeed, until recently, doctors, faced with such a fact, warned of negative consequences, especially during the second and subsequent pregnancies.

And artificial termination of pregnancy for women with a negative factor was a verdict for childlessness.

Fortunately, modern diagnostic and therapeutic methods are able to minimize the unwanted manifestations of the Rh-conflict. Women, if all the recommendations are followed, have a chance of repeated motherhood, regardless of the Rh factor of the blood.

Features of the Rh factor during pregnancy

Erythrocytes are constantly circulating in human blood, on the surface of which there is a special protein - antigen D. Its presence confirms the positive Rh factor of the blood.

Such particles are present in 85% of the subjects. In the absence of such particles, blood is referred to as negative rhesus. These indicators are not abnormal and do not affect health in any way.

During pregnancy, a negative Rh factor can cause pathological processes. This happens when the mother and the fetus have rhesus incompatible. But not all women with a negative factor face this phenomenon:

1. If both parents have a negative Rh factor, the blood of the unborn child will also have such indicators. Therefore, there is no conflict.

2. If the child has inherited a negative Rh from the father, and the mother has positive blood counts, there are no threats to pregnancy.

3. With a positive Rh of the father and a negative mother, the probability of positive indicators in the fetus reaches 75%. In this case, the likelihood of a Rh conflict between the blood of a woman and a fetus is high.

The formation of its own circulatory system in the fetus occurs in the seventh week. The child's blood, which has rhesus-positive proteins, penetrating the placenta into the mother's bloodstream, is perceived as a foreign substance. Leukocytes - cells - "guards" recognize unfamiliar particles and begin to produce antibodies that can fight unfamiliar red blood cells. Such antibodies, penetrating into the developing organism, begin a vigorous activity aimed at destroying blood cells alien to the mother's body.

Such deviations are present in Rh-conflict. But it does not always arise even with different rhesus in the fetus and the mother.

First of all, at the first pregnancy maternal leukocytes encounter unfamiliar antigens for the first time. Therefore, the production of antibodies is rather slow, or it may not start at all. Here, weak maternal immunity plays into the hands. It is the slowness of the white blood particles that can save you from the onset of the Rh conflict.

But with repeated pregnancy“memory” cells are retained in the woman's body, which becomes the reason for the increased formation of antibodies.

The body remembers foreign particles not only after the previous birth. An immune memory capable of recognizing positive blood antigens is present after:

Miscarriage;

Positive blood transfusions;

Medical abortion;

Ectopic pregnancy.

Even if all the unfavorable factors coincided, and the Rh-conflict is inevitable, medicine provides effective methods that can correct the situation.

Methods for diagnosing possible problems with a negative Rh factor during pregnancy

The Rh factor is determined in a woman at the very beginning of pregnancy. It is good if the parents-to-be found out the blood counts even when planning a pregnancy.

If a woman's negative Rh factor is confirmed, she is put on special account. The father will also have to donate venous blood in order to know the likelihood of a Rh conflict.

For women who have a negative Rh factor during pregnancy, it is extremely important to regularly monitor blood counts. Antibodies detected in the blood in time will prevent negative consequences.

Therefore, pregnant women at risk donate venous blood for testing for the presence of antibodies at the beginning of pregnancy every month, after 32 weeks every two weeks, and closer to childbirth after 35 weeks weekly. The threat appears if the amount of antibodies in the mother's blood begins to increase rapidly.

To monitor the condition of the fetus, routine ultrasound examinations are performed. The doctor, first of all, pays attention to the state of the spleen and liver in the baby, as well as the state of the placenta. If deviations are found, you may need:

cardiotocography, which will help track the fetal heart rate, determine the likelihood of hypoxia,

dopplerometry- allows you to find out the speed of blood flow in the placenta and in the fetus, as well as to assess the state of the heart.

Invasive methods of examining the fetus are resorted to only when the antibody titers in the mother's blood are too high. Such examinations can have negative consequences in the form of leakage of amniotic fluid, bleeding, hematomas on the umbilical cord, infections in the amniotic fluid, placental abruption.

But these are the most informative examination methods:

1. During amniocentesis, the amniotic fluid is analyzed, which is taken through a puncture of the fetal bladder. This method allows you to determine the amount of bilirubin.

2. With cordocenosis, blood is taken from the fetus through the umbilical cord. With the help of this examination, all indicators of the baby's blood condition are found out.

What to do if there are abnormalities with a negative Rh factor during pregnancy?

If antibodies are found during the examination, and their number increases, the woman is recommended to be under constant supervision at the perinatal center. In this case, doctors will be able to determine the degree of threat in time and take appropriate measures.

The only way to curb the activated leukocytes in the blood and neutralize the formed antibodies of the mother is the introduction of anti-rhesus immunoglobulin. After the injection, the blood is quickly cleared of "aggressor particles". An injection of immunoglobulin is resorted to at 28 weeks. But there are situations when an injection may be needed at an earlier date.

When serious abnormalities appear in the fetus, they resort to injecting blood with a negative Rh through the umbilical cord. The procedure is carried out under the control of the fetus using ultrasound.

If there is a threat of the appearance of hemolytic disease, artificial support of the vital functions of the fetus may be necessary. This allows you to protect the child from biological exchange with the mother.

How dangerous is a negative Rh factor during pregnancy for an unborn child?

The fetus, losing its own erythrocytes in significant quantities, is independently unable to combat this phenomenon. The active activity of maternal antibodies triggers irreversible pathological processes:

1. Red blood cells are primarily responsible for the delivery of oxygen. A decrease in their number leads to oxygen starvation of the fetus, which significantly affects development. First of all, the brain and heart are affected. The formation of organs and systems during oxygen starvation also occurs with deviations. With severe hypoxia, the fetus may die.

2. The increased amount of bilirubin, which appears in the child's body as a result of the destruction of red blood cells, causes intoxication. The child's brain suffers the most from poisoning.

3. The liver and spleen, trying to restore balance in the blood, intensively produce new red blood cells. As a result of the constant increased load, these organs increase significantly, which leads to a new round of developmental abnormalities.

4. Faced with an imbalance in the blood, the system of synthesis of blood particles, for which the spinal cord is responsible, can be disrupted. This pathology is fraught with hemolytic anemia of a congenital nature.

After birth, such babies may have signs of anemia, manifested by pallor of the skin. In the future, anemia can affect the attention, concentration of the baby. Depression and hypotension may appear.

They may have jaundice, which is associated with elevated bilirubin levels. Large amounts of bilirubin can be observed during the first years of life, which increases the stress on the liver, kidneys, heart and brain. Therefore, serious stress is contraindicated for such children. They are prone to hepatitis.

Only 0.2% of babies have congenital pathologies associated with immune failures.

Specificity of childbirth with a negative Rh factor during pregnancy

If the pregnancy, despite the negative Rh factor, proceeded without abnormalities, the birth takes place naturally. It should be borne in mind that with increased blood loss during childbirth, the activity of leukocytes can be activated and increased production of antibodies can begin. Therefore, during childbirth with a negative rhesus, the mother should always have a portion of rhesus negative blood ready. If necessary, an injection of immunoglobulin can be given during delivery.

If pregnancy with a negative mother's Rh factor was accompanied by a Rh-conflict, a caesarean section is performed. The operation is planned for 38 weeks, if it is possible to bring the problem pregnancy to this date.

In emergency cases, the newborn is given a blood transfusion of a negative Rh factor of the same group as that of the mother and the necessary resuscitation measures are taken.

Feeding such a baby in the early days is not carried out with mother's milk. It still contains antibodies, which, getting into the baby's body, will begin to destroy his red blood cells.

In addition, a woman needs an injection of anti-rhesus immunoglobulin within 72 hours after childbirth. This will avoid problems in subsequent pregnancies. The same injection is given after a miscarriage or abortion. But it is imperative to keep within three days.

Even if the first pregnancy and childbirth with a negative Rh factor passed without complications, memory cells will definitely work during the subsequent pregnancy.

Therefore, if a subsequent pregnancy from a "positive" man is planned, it is better to know in advance about the availability of funds in the maternity hospital. It will be advisable to purchase such an injection yourself.

Remember, Rh incompatibility with your beloved man is not a reason to give up the happiness of motherhood. The problem of Rh-conflict occurs only in 10% of women with negative Rh during pregnancy, and babies with serious pathologies are born only in 2-3 cases out of a thousand problem pregnancies.

However, in case of pregnancy, an inappropriate combination of Rh parents can lead to the so-called Rh-conflict.

Causes

The Rh factor is an antigen (protein) that is found on the surface of red blood cells - erythrocytes. It may be present (Rh positive) or absent (Rh negative). According to medical statistics, about 85% of people are Rh positive, the remaining 15% are Rh negative.

Rh-conflict occurs either during transfusion of Rh-incompatible blood, or during pregnancy of a woman with negative Rh, if the blood in the fetus is Rh-positive.

What's happening?

When the red blood cells of the fetus, carrying the proteins of the Rh system, enter the blood of a mother with a negative Rh, they are perceived by her immune system as foreign. The body begins to produce antibodies to destroy the baby's red blood cells. When this happens, a large amount of a substance called bilirubin appears in his blood, which can damage his brain. As the fetus's red blood cells are continuously destroyed, its liver and spleen try to speed up the production of new red blood cells, while increasing in size. In the end, and they do not cope with the replacement of the loss of red blood cells. A strong oxygen starvation sets in, a new round of serious disorders unfolds. In the most severe cases, this can lead to fetal death.

Who is at risk of Rh-conflict?

Since the presence of the Rh factor is inherited, the threat of Rh-conflict exists only if the expectant mother is Rh-negative (Rh-), and the father is Rh-positive (Rh +). In this situation, in 75% of cases, the mother and child will be Rh-incompatible.

But if a woman has a negative Rh factor, and a man has a positive one, this is not a reason to refuse to create a family.

The first pregnancy of such a couple is likely to go well. If a woman has not previously met with Rh-positive blood, then she does not have antibodies, and therefore, the risk of Rh-conflict with the fetus. During the first pregnancy, not so many antibodies are produced (this is the "first meeting"). If the number of fetal erythrocytes that entered the mother's blood was significant, “memory cells” remain in the woman's body, which in subsequent pregnancies organize the rapid production of antibodies against the Rh factor.

With Rh-incompatible pregnancy, much depends on how it ended. After a miscarriage, Rh sensitization (production of antibodies) occurs in 3-4% of cases, after a medical abortion - in 5-6, after an ectopic pregnancy - in about 1% of cases, and after normal childbirth - in 10-15. The risk of sensitization increases after a cesarean section or if placental abruption has occurred. That is, it all depends on how many fetal red blood cells will enter the mother's bloodstream.

Prophylaxis

In the antenatal clinic, a pregnant woman must be checked for the Rh factor. If it is negative, it is necessary to determine the Rh origin of the father. With the risk of Rh-conflict (the father has a positive Rh factor), the woman's blood is repeatedly examined for the presence of antibodies to the fetal erythrocytes and their number. Until the 32nd week of pregnancy, this analysis is performed once a month, from 32nd to 35th - twice a month, and then weekly until delivery.

By the level of antibodies in the blood of the expectant mother, the doctor can determine the possible onset of the Rh-conflict and draw conclusions about the alleged Rh factor in the child.

In addition, the baby's Rh factor is determined immediately after childbirth. If it is positive, then no later than 72 hours after childbirth, the mother is injected with anti-Rh serum (anti-Rh immunoglobulin), which will prevent the development of Rh-conflict during the next pregnancy.

The same prophylaxis with anti-Rh serum Rh-negative women should be carried out within 72 hours after an ectopic pregnancy, abortion, miscarriage, Rh-positive blood transfusion, platelet transfusion, placental abruption, trauma in a pregnant woman, as well as amniocentesis and chorionic biopsy (manipulations on fetal shells).

Treatment

If antibodies are found in a pregnant woman and their number increases, this indicates the onset of the Rh conflict. In this case, treatment is necessary in a specialized perinatal center, where both the woman and the child will be under constant supervision.