Analysis on a blood group and a rhesus factor enters the sheet of mandatory research during pregnancy. Often, future mothers suggest that only the incompatibility of the reserves of the mother and father causes complications when entering the child. However, the conflict for the blood group can also lead to the disease of the future kid.
Checking the blood group and a rhust factor in pregnant and future fathers, doctors not only make a mark in the case of emergency blood transfusion, but also predict the course of pregnancy and the peculiarities of the neonatal care.
It is known that the rhesus conflict until the invention of immunoglobulin therapy often led to the unbearable of the fetus. Women with negative rhesus persistently suggested not to interrupt pregnancy, as it could prevent further plans for healthy offspring.
Probably, therefore, in society, it is so well known about the effect of the Rh factor for pregnancy. However, antibodies are also produced, if the blood type is not coincided.
When blood transfusion from the donor to the recipient, the doctors necessarily take into account whether the rhesv factor coincide. During pregnancy, the erythrocyte of the blood of the mother and the future kid is also found in the process of intrauterine development, as well as when the donor material is introduced. If the types of blood cells are missed, the maternal body "includes" the protective reaction of immunization.
Erythrocytes contain antigens A or B, in plasma - antibodies α or β. The blood of the first group does not contain antigens, the fourth - antibodies. Antigens and antibodies are distributed as follows:
- group I (o) - antibodies α, β, absent antigens;
- second II (a) - antigen A, antibody β;
- third III (B) - B and α;
- fourth IV (AV) - A and B, there are no antibodies.
Antigens and antibodies called one letter (A and α, B and β) should not be together. The combination of antibodies of the same name and antigens leads to the destruction of the erythrocytes, violating the oxygen transfer system to the tissues. This is a conflict for the blood group (or avo conflict).
Is the incompatibility of the blood groups of future parents?
In accordance with the laws of inheritance, when parents of parents coincide, hemolytic disease of this type or does not develop, or has a low probability of manifestation. The avo conflict is most likely if the maternal organism is characterized by the first group of blood, and the baby inherits the other option. In such a situation, antigens that are in the blood of the fetus, placental blood and in the octoploid waters cause a response in the body of a pregnant woman.
Antibodies that destroy alien erythrocytes are produced in the blood, releaseing hemoglobin (hemolysis process). Most often, the main "blow" falls at the time of childbirth, but occasionally blood hemolysis can begin directly during pregnancy.
Combating excess hemoglobin - liver function. Hemoglobin is processed in bilirubin and excreted from the body. If bilirubin is too much, the liver is under stress without coping with the cleaning function, and other bodies of the child may suffer.
To control the presence of antibodies, the doctor may assign analyzes, starting with 30 weeks of pregnancy, repeating them every month before childbirth. The symptoms indicating the consequences of the immunological misband of blood groups are also being studied. When evaluating the state of the baby and the fetotic placental complex on the ultrasound, the doctor draws attention to the presence of edema of the placenta, an increase in the size of the child's abdomen, which does not correspond to age norms, motor activity, tone.
Similar changes in development may indicate other diseases. Therefore, for the diagnosis of AVO conflict, such procedures may also be carried out as amneenocentsis (fence of an oily fluid for calculating the number of bilirubin) or cordocentsis (seizure of blood from the umbilical ultrasound). After the advent of the newborn, one or a series of analyzes in the newborn is carried out to track the dynamics of bilirubin production.
The positive difference between the AVO conflict from the rhesus factor: with the following states of the baby's waiting, the chances of the occurrence of the disease do not increase, but decrease.
The most frequent manifestation of the AVO conflict is expressed in a hemolytic (or physiological) jaundice in a newborn. Her symptoms of skin staining and scool eyes in yellow, and sometimes affect neurological status. Children become restless, crying or, on the contrary, inactive, sluggish, sleep more than the age of age.
In severe cases, the bilirubin attack has an impact on the brain and other vital organs of the newborn. But most often, physiological jaundice takes place in 2-3 weeks with a small support (and constant control) of the neonatologist and pediatrician.
The main treatment is to help the body. As with the pregnancy, if a high titer of group antibodies was found, the doctor may assign intravenous infusion (or dopping from a bottle) glucose, receiving vitamin complexes designed to facilitate the process of cleaning the blood of the liver. If the child has a high bilirubin content, it is not necessary to resist the appointment of additional nutrition or medical procedures. As a rule, it does not interfere with breastfeeding, and timely helping the baby will facilitate his condition and will help proper growth and development.
If necessary, the doctor may appoint other medicines, including with the condition of hospitalization. If the jaundice begins to influence the brain cells, the treatment is carried out with constant medical control.
Recently, they often talk about the benefits of late intersection of umbilical cord after delivery. Publing the umbilicals are delayed at the time of termination of its ripple, which allows the child to receive nutrients after birth. This is exactly the procedure that is prohibited if the mother's blood group is excellent from the Father's Blood Group. Even if the likelihood is that the child inherited the mother's blood group, above the possibility of conflict in the blood group, the umbilical umbilical should be cross immediately after birth. It will save the baby from possible problems.
However, the main thing when yellow newborn is prevention. In the process of pregnancy, the mother does not feel discomfort from immunological incompatibility. Therefore, if there is a possibility of a conflict in a blood group, it is necessary to pass research in a timely manner, planning to conduct generic activities with a doctor and remember the importance of a healthy lifestyle.
Content
Future parents still when planning the birth of a child must take an analysis to identify blood reveament. It is necessary to determine the possible incompatibility of a man and a woman in a timely manner. Such a study will help to prevent adverse effects - the likelihood between the child and the Mom of the Rus-conflict.
Resh conflict during pregnancy
In the process of conception, the embryo from one parent receives a D-protein located on top of red blood cells. If there is a rhesus-antigen D, blood is considered positive, and in its absence - negative. Rhow-conflict is when the future milf has a negative RH, and the partner is positive, because by statistics 50% of children receive a Rh factor from the Father. In other cases, the problem does not occur. The conflict of rhesis during pregnancy threatens spontaneous miscarriage, premature placental detachment, hemolytic baby disease.
Resh conflict with first pregnancy
In women with RH (-), only 10% of cases develop a blood conflict, if they become pregnant for the first time. This is due to the generation of immunoglobulins 1 type, which cannot pass through the placenta and join the blood flow of the fetus due to major sizes. In order for the erythrocytes of the child and the mothers antibodies to meet, and their agglutination (sticking), they need to connect between the pocent and the wall of the uterus. If earlier the woman did not make abortions, and it was also not overflowing by blood drugs, then the rhesv conflict during the first pregnancy is excluded almost completely.
Resh conflict with second pregnancy
Rhose-sensitization during the re-entering of the child occurs more often. In this case, the erythrocytes of the baby penetrate into the vessels of the mother and run a humoral immune response, after which IgG antibodies are produced. Their size is small, so the placental barrier is easily overcome. Antibodies penetrate the blood flow and destroy red blood cells, causing hemolysis. Resh conflict with a second pregnancy and all subsequent, especially with a small time interval, is reflected negatively on the health of the fetus.
Resh conflict during pregnancy - consequences for a child
For the future, the baby RH conflict is dangerous to the occurrence of hemolytic disease. This is a very risky state when the baby still has an empty form of the disease in the womb, ascites. In immunological incompatibility, the child can be born in particularly serious condition or dead. With less severe complications, the main consequences of the rhesus conflict for a child are an increase in liver after birth, spleen and other internal organs, pale leather, anemia.
Already in the first day after birth, jaundice appears (with a yellow form), there may be a lack of blood circulation, cardiomegaly (increase in the mass and sizes of the heart). Other consequences of rhesv conflict:
- fast reductions in eyeballs;
- generalized convulsions;
- high-tone cries;
- asymmetric spasticity;
- deafness.
Resh conflict - reasons
As it turned out, the rhesus conflict pregnancy occurs if the mommy has a negative factor, and the fruit Rh is positive. However, the destructive action after the "dating" of two organisms does not occur immediately. Only for a period of 8-9 weeks, and in some women and six months later, immunoglobulins occur, which can penetrate the placenta.
When the bloodstream between the woman and the fruit is enhanced, then the number of antibody antibodies in the body of the kid, which increase the risk of pathologies. Immunological conflict sometimes occurs during the sensitization of the RH (-) of a woman who occurred during her birth from RH (+) Mother. There are other reasons for the conflict, if a woman with RH (-) had the following pathologies:
- diabetes;
- cesarean section on previous births;
- gestosis;
- artificial interruption of pregnancy;
- flu;
- genetic heredity;
- ectopic pregnancy;
- blood transfusion donor.
Rhow-conflict during pregnancy - symptoms
Pregnant woman does not detect any specific clinical manifestations. Blood conflict during pregnancy is manifested only by the pathologies of the fetus. Sometimes the development of incompatibility even leads to intrauterine death or to miscarriage. The kid can be born dead, premature, with a swelling, anemic or yellow form of a hemolytic disease. The main symptoms of the reserves conflict during the tooling of the fetus and after the inflection of the baby:
- the appearance of immature red blood cells;
- hypoxic damage in internal organs;
- anemia;
- thickening placenta;
- growth of the abdomen of the fetus;
- head tissue swelling;
- bilirubinization intoxication of the CNS;
- increase the oilyoper water.
Analysis on rhesv conflict during pregnancy
To prevent the likelihood of a rhesus conflict during an ending, the mammy with RH (-) assign an analysis to the rhesus conflict (on antibodies), which it should take place monthly. If there are antibodies (any titer), pregnant women under 20 weeks are observed in local consultation, after which they are sent to specialized clinics to determine the tactics of treatment and delivery times. Since 18 weeks, it is estimated to evaluate the state of the fetus and other signs of rhesus conflict with the help of an ultrasound (ultrasound research).
Prevention of rhesus conflict
Antenatal prevention is important, that is, antenatal, starting with the analysis on RH conflict, which should be held from the first days of pregnancy. In the absence of antibodies, a woman at the age of 28 is an intramuscular injection (injection) of anti -usus immunoglobulin, preventing further developing them. If after the birth of the RH baby is negative, then you can not be afraid of the occurrence of hemolytic pathology. Mama is cling another dose of immunoglobulin to prevent the risks of immunological incompatibility in the process of the following pregnancies.
In the case of the development of RH sensitization on any time, the prevention of the rhesus conflict during pregnancy requires special attention: after 32 weeks of blood tests spend 2 times a month, and before childbirth - weekly. In the initial period, the woman is put in a special clinic, where from 22 to 32 weeks do intrauterine transfusion, when the fetus is poured the desired blood group. This gives a high possibility of full-fledged tooling and excludes an ectopic pregnancy in the future.
The uniqueness of the blood group of each person is special. There are four of them four: 0, A, B, AB (first, second, third, fourth). Also, each inhabitant on Earth is one - the only one is positive or negative. These blood data is important in medical interventions, with blood donation, during the toasting of the fetus in women. They are no less important at the very beginning of the formation of the fetus. In modern maternity practice, there are cases of incompatibility of the blood group of the mother and child. In a situation where, for example, rhesus factors with a fruit of different, mom needs close observation of the doctor.
A woman has a positive rezv factor. Perhaps earlier it was conducted or introduced some therapeutic drugs that are based on the components of blood cells. As a result, sensitization was started in tissues and cells - increased sensitivity of cells or tissues to the injected stimulus, the rhesus factor is something like allergies. For this reason, the body begins to carry out protective reactions and produce, absolutely safe for the body of the mother, but potentially harmful to the kid.
An important point is the possibility of improving sensitivity only when the mother has a positive child. If the polarities are inverse, then it is no better. The female organism will begin a protective reaction in any of the cases by destroying the editoocytes in the baby's blood, which can lead to severe anemia or, worse, hemolytic disease.
From a long time, the weak or dead children were born. Modern medicine can solve this problem - scientists have developed a drug and allocated immunoglobulin. This is an immunostimulating component of our blood. Having made such an injection on the 28th week of pregnancy, the danger of childbirth is reduced almost to zero. When a child has a positive rear factor, the need for injection disappears.
Resh incompatibility
It follows from paragraphs above, which is observed in both cases of the polar inconsistency of the rezes of the mother and the child. Such a deviation can be fraught for the baby. The fact is that the female organism begins to "defend" from the fetus: the resulting antibodies in the child's blood destroy its red blood cells by changing blood structure. With each subsequent pregnancy, the risk is becoming higher and higher. Doctors do not advise women suffering from reserves-incompatibility of blood, give birth more than two times due to the high probability of miscarriage.
The launch of two groups of blood on each other is on the twelfth week of pregnancy, since it is at this fetus that the formation of his own blood begins. The child begins to progress the erythrocyant failure, hypoxia () of tissues and organs, which entails a serious deviation in the metabolism. For the mother, this is not a significant threat, but for a child it is theoretically mortal danger.
As mentioned earlier, the danger in such a deviation, mainly threatens the child. In the case, even if it is born and survived, he can have serious illnesses. The most common case is when the newborn appears to light with various forms and dies for several hours. If the disease has not yet managed to progress, then this is a little depletion of the child's death. Such cases are extremely rare, since such children have defective blood and its circulation is properly.
One of the most common diseases of the newborn in the incompatibility of blood and the rhesis is a yellow form. It is characterized by the fact that some internal organs increase in their volume, and by itself proceeds very hard and quickly progresses. Such symptoms can be noticed in the first days of life. The child literally "explodes", which adversely affects only the parent organism. The decay of the erythrocytes stimulates the growth of bilirubin, which is very poorly affected by the work of the internal organs, but if it is processed in the bloodstream "depot, it is not dangerous for a child or for the mother.
Abortion in incompatibility
A woman with absolutely any rhust factor cannot be taken abortion - such a fact states modern medicine. To date, there is a medical intervention of different levels, allowing even a sick fetus to keep life. The main thing is that it is necessary to remember - abortions in the incompatibility of blood and rear factors are not allowed.
Group conflict
In addition to the considered incompatibility, there is also a group conflict of the mother and child. With different mother and child, special cells are beginning to be produced in the body, causing the destruction of the child's blood cells. Such incompatibility of the blood of the mother and the child is more common than incompatibility in Resh.
Causes of incompatibility
If foreign cells and bacteria get into the body, it begins to fight them and produce antibodies, while coming to them and producing further immunity to them. This is happening with maternal and infant blood groups.
The reason for the incompatibility of the mother and the child in the reserves-factor and the blood group is the merger of initially different parents. This is the answer to the question: why incompatibility occurs.
Pregnancy planning
The first step before the fetal conception should be rhesus! Load the values \u200b\u200bof blood in life, a person is not worthwhile - in the above paragraphs indicate weighty arguments confirming its significance.
Do not be afraid to plan a pregnancy, because the birth of a child is the most important step in life. Do not forget to contact if necessary for help to doctors.
Why does the mother-fruit conflict arise?
The "mother-fruit" conflict occurs when the blood and fetus is incompatibilities, when antibodies damaging the erythrocytes of the fetus are formed in the blood of the mother, which leads to the hemolytic disease of the newborn. The basis of this phenomenon is the difference in human blood in groups depending on the presence of different antigens in the erythrocytes, and in plasma - general group antibodies. The number of group antigens is large, and they determine the blood group. The child receives the blood type system from the father and mother, according to the law of Mendel. Practically determine the group is not difficult. Not all antigens are equally common and equally strong, so not everyone causes a serological conflict. Most often, incompatibility of the Rh Factor and the AV0 system occurs.
AVO System Conflict
Iso immunization can develop as a result of the incompatibility of the blood of mother and fetus according to the AVO system, when the mother is about (i) a blood type, and the fetus has any other. Antigens A and in the fetus can penetrate during pregnancy in the blood flow of the mother, leading to the development of immune alpha and betta antibodies, respectively and the development of the reaction fetus
Antigen antibody. The group incompatibility of the mother and the fetus, although it occurs more often than incompatibility of the Rh Factor, the hemolytic disease of the fetus and the newborn occurs easier and, as a rule, does not require intensive therapy.
Why is an immunological conflict?
The first blood group does not contain antigen A and B antigen erythmocytes, but there are α and β antibodies. In all other groups there are such antigens and therefore the first group of blood, having met alien to her antigens A or B begins with them "Emoxy", destroying the red blood cells containing these antigens. It is this process that is an immunological conflict on the system Av0.
A little physiology.
Let's deal with what a blood type is and why such a conflict may arise during pregnancy. Recall the school biology. Blood consists of blood cells (erythrocytes, leukocytes) and plasma (liquid part). Erythrocytes look like red biconed discs. 
In the erythrocyte there is a huge amount of hemoglobin - a complex protein, which can carry oxygen. It is estimated that each erythrocyte contains more than 3 million hemoglobin molecules.
Also on the surface of the erythrocytes can be located special proteins, so-called agglutinogens. Their presence of each person individually. If the erythrocytes, on which there are certain agglutinoenes, fall into the human body, in which there are no such agglutinogen, it perceives them as foreign and produces special antibodies against them - agglutinins. The purpose of such antibodies is the destruction of alien erythrocytes. Approximately this situation occurs when conflict of blood groups of mom and child during pregnancy. The same happens when overflowing incompatible blood.
Agglutinogen is actually a huge amount, but in practical medicine usually determine only a few. These are agglutinoogen A, B, and D. precisely on the presence of these agglutinogen and judge by the group of human blood:
I group - on red blood cells there are no agglutinogen A and V.
Group II - Erythrocytes are agglutinogen A.
III group - on red blood cells there are agglutinogen V.
IV Group - on red blood cells there are agglutinogens A and V.
A agglutinogen D defines the reserves factor. If it is on erythrocytes - blood is considered rhesus-positive, and if there is no - rezes-negative.
Who needs to be afraid of the conflict on the blood group?
Theoretically, such a problem may occur if the mother with the future kid has different blood groups:
- woman with I or III blood group - the fruit with II;
- woman with I or II group of blood - a fruit with III;
- woman with I, II or III group - fruit with IV.
- receiving blood transfusion in the past;
- survived several miscarriages or abortions;
- previously, the child who had developed a hemolytic disease or a lag of mental development.
- woman with i group + man with II, III or IV;
- woman with group II + man with III or IV;
- woman with III + man with II or IV.
What contributes to the development of the conflict?
The development of a conflict in blood groups protects the correctly functioning and healthy placenta. Its special structure does not allow the blood of the mother and the fetus mix, in particular, thanks to the placental barrier. However, it can still occur when disrupted the integrity of the placenta vessels, its detachment and other damage or, most often, during childbirth. Fruit cells that have fallen into the maternal bloodstream, in the case of their alienity, cause the production of antibodies that have the ability to penetrate the fetus and attacks of its blood cells, as a result of which hemolytic disease occurs. The toxic substance of bilirubin, sampled as a result of such an impact in large quantities, is able to damage the organs of the child, basically the brain, liver and kidney, which can threaten the serious consequences for the physical and mental health of the baby.
Manifestations of group conflict, its treatment and prevention
Pregnant woman will not feel any signs of the development of the conflict in blood groups. A blood test will help to learn about his occurrence, which will show the high titer of antibodies in the blood of a woman. In the development of the hemolytic disease of the fetus and the newborn can be observed:
- swelling,
- jaundice
- anemia,
- increased spleen and liver.
Sensitization by the AVO system is not a big problem. It is important to know about it, twice for pregnancy, check the titer of antibodies and not to reassure the pregnancy, since it is the celebrities that give the heaved molds of the GBN that require replaced blood transfusion.
Some gynecology doctors regularly prescribe pregnant women with the first blood group analysis on group antibodies in the event that there are prerequisites for this. In fact, this is happening very rarely, due to the fact that the conflict on the AV0 system usually does not entail serious consequences and causes jaundice only in a born child, practically without affecting the fruit in the womb. Therefore, there are no such mass studies here as during pregnancy Resh-negative woman.
In the conflict on the system of avo, the fruit does not ill, and the newborn has no anemia. However, the manifestations of jaundice in the first days of life are very heavy and many children require treatment.
In most cases, the hemolytic disease of the newborns about the AVO system is not repeated from subsequent children, (that is, repeated pregnancy proceeds as a rule. Avo conflict in pregnant women is not held.
A distinctive feature of immunoconflict on the AVO system is a later appearance of signs of hemolytic disease in a newborn. As a rule, only the 3-6th day of life begins to appear the yellow painting of the child's skin, which is often stated as physiological jaundice, and only with severe forms of hemolytic disease, which is observed in one case for 200-256 genera, the correct diagnosis is determined in a timely manner. Such a non-timely diagnosed forms of hemolytic diseases of newborns on the AVO system often leave the consequences in children.
The hemolytic disease of the newborn requires compulsory treatment in order to avoid the development of severe complications. The brighter the symptoms are expressed, the more intense the conflict, to confirm the blood test to the increased content of bilirubin. The meaning of treatment is to remove antibodies from blood damaged red blood cells and excessive bilirubin, for which phototherapy and other symptomatic treatment is carried out. In the event that this does not help, or the level of bilirubin in the blood grows very quickly, then resort to the procedure for transfusion of blood newborn.
Future parents who fall under the risk of developing such a conflict, it is necessary to know that, firstly, the likelihood of a real conflict for blood groups in practice is very small, and secondly, it most often proceeds much easier than rezv conflict, and cases of severe flow Comparatively rare, so the conflict on the AB0 system is considered less dangerous to the health of the baby.
The blood of a person has two important characteristics - a blood group (AB0 system) and a rhesus factor (the rhesus system). Most often, during pregnancy, there are problems with hatching due to incompatibility precisely by the rhesus system, so we will analyze it first.
What is a rhesus factor?
Rh Factor (RH) - This is an erythrocytarian antigen system Rhus. Simply put, it is a protein located on the surface of the red blood cells (erythrocytes).
People having this protein are rhesus-positive RH + (or RUS-positive). Accordingly, negative Rh- (or negative reserves) indicates the absence of a given protein in human blood.
What is a rhesus conflict and what is it dangerous for the fetus?
Resh conflict - Immune response of the organism of the mother to the appearance within itself "alien" agent. This is the so-called struggle of the bodies of the reserves-negative blood of the mother with the bodies of the reserves-positive blood of the child, which is fraught with the appearance of hemolytic anemia or jaundice, hypoxia, and even water fetus.
During the first pregnancy, the blood flow of the mother and the child function separately from each other and their blood is not mixed, but during previous births (perhaps during abortions and miscarriages) may occur the child's blood into the blood of the mother, and as a result, a woman's body with negative rhesus -Factor will produce antibodies to the antigen before the next pregnancy occurs. Therefore, re-pregnancy may still end in the intrauterine death of the embryo, and as a result, miscarriage.
The first pregnancy usually proceeds without complications, since the blood of the mother has no antibodies to the "alien" baby's blood.
Simply put, the blood cells of the fetus penetrate through the placenta in the blood of a pregnant woman and in the incompatibility of the blood, the body of the future mother perceives the baby as a "stranger", after which the protective reaction of the body of the woman produces special antibodies that destroy the blood cells of the child.
The destruction of erythrocytes of the fetus antibodies is called hemolysis, which leads to anemia in crumbs. The condition of the pregnant woman does not deteriorate, and the woman does not even suspect the preceding threat to the health of the baby.
When does the rhesus conflict arise during pregnancy?
With a positive rezes of Mother, the rhesus conflict will never arise, whatever the blood of the child's father.
With a negative reserves, both future parents - there is also no reason for excitement, the child will also have a negative rhesus factor, it cannot be different.
With a negative rezes-factor of blood in a pregnant woman and positive by the father of the child, the baby can inherit both the reserves of the mother and the Father's Rus.
If the father of the child is a rhesus-positive, homozygoten, and has a DD genotype, in a pregnant rhesus-negative, then in this case all children will be rush-positive.
If the father is rhesus-positive, heterosigoten, and has a DD genotype, and a pregnant rhesus is negative, then in this case the child may be born both with a rhesus-positive and with a rhesus-negative factor (the probability in this case is 50 to 50).
Therefore, a man is also important to pass the blood to the rhesus factor with the definition of a genotype with a negative group of blood in a woman planning a pregnancy or a begging fruit.
With the probability of developing a rhesus conflict, a blood test is prescribed for the presence of rhesus antibodies.
Table 1 - the likelihood of the development of rhesv conflict during pregnancy
Judging by the above table, it can be said that the rhesus conflict occurs only with a negative reserves in a pregnant and positive rezes at the father of the child, and only in 50 cases from one hundred possible.
That is, not necessarily during pregnancy there must be a rhesus conflict. The fruit can inherit both the negative rhesus from the mother, then there will be no conflict.
It should also be noted that during the first pregnancy, the antibodies are produced for the first time, and therefore they have a better size than during re-pregnancy. It is harder to penetrate the placental barrier in the blood of the child with large-scale antibodies in the blood of the child, they can't "crawl through the placenta walls, and during the next pregnancy are other, more modified IgG antibodies. They are smaller, and their ability to penetrate the placenta walls is much higher, which is more dangerous for the fetus. Then the titer of antibodies increases.
Therefore, primary women should not worry about the rhesus conflict, just be vigilant (it is enough to determine the titer of antibodies once a month), and rejoice the period of pregnancy, because there is ahead of care for the care of crumb and its upbringing.
Prevention and treatment of rhesv conflict
At first pregnancy (i.e., in the past, there was no abortion and miscarriage) for the first time analysis on antibodies spend from 18-20 weeks 1 time per month (up to 30 weeks), then from 30 to 36 weeks - 2 times a month, and after 36 weeks of pregnancy - 1 time per week.
When re-pregnancy begin to donate blood on antibodies from 7-8 weeks of pregnancy. If the titer is not 1: 4, then take this analysis once a month, and with raising the titer - more often, once every 1-2 weeks.
Admissible (normal) with "conflict" pregnancy is the titer of antibodies to 1: 4 inclusive.
Critical is the titers of 1:64, 1: 128 or more.
If there is a risk of developing "conflict" pregnancy, but up to 28 weeks of the antibody have never been detected (or were discovered, but not more than 1: 4), then later they may appear in significant quantities.
Therefore, in preventive purposes, pregnant women in 28 weeks are introduced by human antuxustic immunoglobulin D, which block the work of a woman's immune system to destroy alien bodies, i.e. After the injection, the woman's body will not produce antibodies that destroy the blood cells of the embryo.
The injection of immunoglobulin is advisable in the absence of antibodies in the blood of a pregnant woman, since in other cases it is just useless.
Vaccine does not have a negative impact on the health of the mother and the fetus, it is completely safe.
After the work of the injection (subject to the absence of antibodies in the blood shortly before the injection or at least with their titer, no more than 1: 4) is not reasonable for blood antibodies, since a false positive result may be observed.
It is also advisable to monitor the heart activity of the baby, regularly conducting cardiotokography (CTG), starting with a 26 week period.
Dopplerometry or Doppler is an ultrasound study of blood flow in the fruit vessels, in the uterine arteries and umbilical cord.
With the suffering of the fetus, the rate of blood flow (V MAX) in the average-creation artery will be higher than the norm. When this indicator approaches the 80-100, an emergency COP is produced so as not to give the baby to die.
If the growth of antibodies is observed, and the state of the child's health deteriorates, then this indicates the development of the hemolytic disease of the fetus (abbreviated GBP), then treatment is necessary, which is a treatment in the intrauterine transfusion of the fetus.
With the "conflict" course of pregnancy during ultrasound research, the following signs of the hemolytic disease of the fetus may be observed:
- the increase in the abdomen of the fetus due to the accumulation in its abdominal cavity of the liquid, as a result of which the baby takes the "Buddha Pose", spreading the bent legs to the sides;
- outlet of subcutaneous fatty tissue of the head (on ultrasound, the "double circuit" of the fetus head);
- increased heart size (cardiomegaly), liver and spleen;
- the thickening of the placenta to 5-8 cm (norm 3-4 cm) and the expansion of veins of umbilical umbilicals (more than 10 mm).
Due to the increased ethony, the weight of the fetus will increase by 2 times compared with the norm.
If there is no possibility to carry blood transfusion, then it is necessary to discuss the question of early delivery. It is impossible to slow, and if the light kids have already formed (the 28th embryonic week and more), then it is necessary to produce a relative-mindedness, otherwise a pregnant woman risks losing a child.
If the child reached 24 weeks, then you can conduct a series of injections for ripening light fetus so that it can breathe independently after an emergency delivery.
After the baby appears to the light, it is replaced by blood transfusion, plasmapheresis (blood filtering from hazardous cells) or phototherapy, otherwise the destruction of red blood cells will occur further.
The modern generic resuscitation service is able to come out a premature baby even when he appears on the light of the 22nd week of pregnancy, therefore, in a critical case, trust the salvation of the life of the baby by qualified doctors.
Group incompatibility of mother and fetus
Less likely, but still there is incompatibility for the blood group.
Blood type - This is a genetically inherited combination of surface antigens (agglutinogen) of the Erythrocytes of the AB0 system.
Each person belongs to a specific blood group over the AB0 system: A (II), B (III), AB (IV) or 0 (I).
This system is based on a laboratory analysis to determine two agglutinogen (a and b) in human blood.
- I Blood Group - This is a group of 0 ("zero") when, when analyzing blood to group affiliation on red blood cells, agglutinogen nor A, nor B.
- The II group of blood is a group A, when only agglutinogens are contained on red blood cells.
- III Blood Group is a group B, that is, only agglutinoogens B are detected.
- IV blood type is AB group, on red blood cells, both antigens A and B.
Group incompatibility is often observed if there is a blood group in the future mother, and the future of the child is IV-Aya, the fruit will inherit the II or III group of blood. But there are other non-accompatibility options for the blood group (see Table 2).
Table 2 - the likelihood of the development of a conflict for a blood group during pregnancy
Typically, group incompatibility proceeds significantly easier than rear, so the conflict for the blood group is considered less dangerous, and the kids who have moved the conflict over the blood group, are born with a conventional jaundice, which soon passes.
