The article explains the risk of Rh conflict during pregnancy. Recommendations are given to future parents on the prevention of probable complications.
Having become pregnant, a woman is registered at the antenatal clinic. She has to go through a lot of examinations, pass tests. An analysis will also be mandatory, which will help determine the blood groups of future parents and their Rh factors.
The Rh factor is a specific property of human red blood cells, which is due to the presence of an antigen protein. Other group systems do not affect the presence of the Rh factor in the blood. Each person is born with a certain Rhesus factor. It remains unchanged until death and is inherited by children.
How is the Rh factor determined?
Rhesus factor in medicine is indicated by a combination of two Latin letters Rh. If a Rhesus antigen is detected in red blood cells, then the blood of such a person is considered Rh-positive (Rh +). There are about 85% of such people in the world. The remaining 15% are carriers of Rh-negative blood
Holders of a negative rhesus do not experience particular inconvenience and are not considered sick. But if a woman is going to become a mother, then she needs special attention.
If the antigen and antibody of the same name are present in the blood, then their connection leads to a red blood cell bonding reaction
Glued red blood cells are not able to fulfill the function of oxygen delivery. In the bloodstream of healthy people, the antigen and antibody of the same name are not found.
Rhesus conflict is observed when Rh-positive blood is mixed with Rh-negative. The blood of the fetus becomes incompatible with the blood of the mother. All systems of the mother’s body will fight against the appearance of a foreign protein in it
This happens when inheriting the rhesus of the father, with immunological incompatibility of blood groups: maternal and child. With incompatibility of blood groups, the dangers are less than with incompatibility of the Rh factor.
Rhesus affiliation is determined in several ways. It depends on whether special laboratory equipment is available. In its absence, rapid methods for determining the Rh factor are carried out:
- using a universal reagent; the tube does not heat up
- on a white flat plate without tube heating
Rhesus affiliation is determined by fresh, non-clotted blood. It is taken from a finger or from a vein.
For the express method, universal serum is used, which is suitable for all blood groups. Serum is prepared in a special way. It is used when carrying out procedures for immunization of pregnant women. Adhesion of red blood cells in a test tube indicates that there is an Rh antigen in the blood.
Blood Type Compatibility Chart
The body of a mother with a negative Rhesus perception of the fetus, which inherited the positive Rhesus of the father, as an alien. As a result, antibodies are produced that attack and destroy the fetus.
Sometimes this affects the development, normal growth of the baby. But serious consequences are also possible: the antigens present in the blood can cause fetal death of the fetus, miscarriage
On her own, a woman cannot determine by her well-being that she is at risk of developing a Rhesus conflict. The main sign is the presence of antibodies in her blood
- the fetus develops a hemolytic disease, which is manifested by anemia, a violation of the activity of internal organs
- the baby has jaundice
- there is a risk of fatal hypoxic damage to the brain and heart for the fetus
The reason for the Rhesus conflict:
- cesarean section
- various complications, bleeding before or during childbirth caused by placental disorders or its detachment
- various procedures such as chorionic biopsy, cordocentesis or amniocentesis
- with gestosis, diabetes, after the flu or ARI
- after intrauterine sensitization of the expectant mother
A woman is at risk for developing Rh conflict during complications during pregnancy (toxicosis, jumps in blood pressure, infectious diseases). They will learn about possible sensitization after the woman has passed all the tests and the Rhesus affiliation of the future parents and their blood groups will be determined
Rhesus factor blood test
It is impossible to independently find out that a pair does not fit each other by blood. But if a woman does not become pregnant for a long time from a partner, or if miscarriages become the outcome of pregnancy, then doctors should seek help. A “sterile” couple, having passed all the necessary tests and following the recommendations, will be able to conceive a baby, and a woman will successfully endure it
The first step in examining a pregnant woman for the presence of antigens is to determine the Rh affiliation of future parents. Such diagnostics are recommended before conception, or at the beginning of pregnancy. With negative rhesus of both partners, further research is not carried out, since the conflict is excluded.
Important: if the patient’s pregnancy ended in a miscarriage or had an abortion, the fetus died in the womb or the baby born had a hemolytic disease, then there is a high risk of Rh conflict
To find out if the fetus suffers from a lack of oxygen in the Rh conflict, you must regularly undergo ultrasound diagnostics. Ultrasound is prescribed for the period of the 20th week of pregnancy and ending with the 36th week. The last time an ultrasound is prescribed before childbirth. This allows you to observe the growth and development of the baby.
The development of the fetus is also judged by conducting research on amniotic fluid (amniocentesis) and examining umbilical cord blood (cordocentesis). Diagnosis of this type is carried out in the last trimester of pregnancy. Analysis of cord blood, how much anemia develops in terms of hemoglobin, bilirubin and other indicators.
What do antibodies mean?
In the pregnant woman’s body, only by the 7-8th week compounds of the protein structure — Rh antibodies — begin to be produced. Prior to this, there are no Rh antibodies in the bloodstream of the mother that can harm the fetus.
The first pregnancy is characterized by the development of large antibodies. It is not easy for them to penetrate the placenta to the fetus. But in subsequent pregnancies, the production of other antibodies against the Rh factor occurs.
Antibodies are smaller, but their presence is more harmful for the child, since it is easier for them to pass through the placenta and they are more aggressive. Therefore, the female immune system reacts during the subsequent gestation of the fetus to the Rh antigen faster and stronger.
Rhesus conflict in the second and subsequent pregnancies
If a woman has a baby for the first time, then the incompatibility of blood groups of future parents will not cause a Rhesus conflict, since the number of antibodies produced is small.
A second pregnancy increases the risk of conflict. This means that, during childbirth, umbilical cord blood with protective antibodies - “memory cells” - enters maternal blood. Thus, the mother's body becomes susceptible to the Rh antigen. The placental barrier of the antibody overcomes and destroys the red blood cells of the fetus.
Maximum risk for women
Rhesus sensitization does not threaten the mother's body. After a difficult pregnancy and childbirth, the mother’s problems with the presence of a Rhesus conflict are exhausted. But immunization that has occurred can affect the recurrence of the situation during subsequent pregnancy.
The consequences of Rhesus conflict for the fetus
A child with a Rhesus conflict develops a hemolytic disease, swelling, jaundice appear, and the spleen and liver increase. In the blood, the indicator of bilirubin increases, which poisons a small organism.
Favorable prognosis: a born child is highly likely to develop mild hemolytic anemia. In this case, jaundice and dropsy are absent.
In more severe forms, hemolytic anemia with jaundice occurs. But the most severe form of the disease is exacerbated by jaundice and dropsy. A child may die in the womb
Rhesus conflict treatment
Doctors can decide on intrauterine blood transfusion for a child up to 34 weeks of pregnancy, which improves the condition of the fetus. Transfusion is carried out through the umbilical cord. Thus, the development of anemia in the fetus can be avoided.
In severe cases, a decision is made to stimulate preterm labor. A born child is treated for jaundice, a phototherapy course is carried out (with laying out under special blue lamps). Repeated blood transfusions may be needed. In some cases, treatment is not required at all.