Women's concern about the negative Rh factor during pregnancy is justified.
Indeed, more recently, physicians, faced with such a fact, warned about the negative consequences, especially during the second and subsequent pregnancies.
Artificial termination of pregnancy for women with a negative factor was a sentence for childlessness.
Fortunately, modern methods of diagnosis and therapy can minimize the undesirable manifestations of Rh conflict. Women, while observing all the recommendations, had a chance for repeated motherhood, regardless of the Rh factor.
Features of the Rh factor during pregnancy
Erythrocytes constantly circulate 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 subjects. In the absence of such particles, blood is referred to as negative rhesus. These indicators are not abnormal and in no way affect health.
During pregnancy, a negative Rh factor can cause pathological processes. This happens in the case when the mother and the fetus 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 future child will also have such indicators. Therefore, there is no conflict.
2. If the child inherits negative Rh from the father, and the mother has positive blood counts, there are no threats to the pregnancy.
3. With a positive rhesus of the father and a negative mother, the probability of positive indicators in the fetus reaches 75%. In this case, the likelihood of the Rh-conflict between the blood of the woman and the fetus.
The formation of its own circulatory system in the fetus occurs in the seventh week. The blood of a child with positive rhesus proteins, penetrating through the placenta into the bloodstream of the mother, is perceived as an alien substance. Leukocytes - cells - "guards" recognize unfamiliar particles and begin to produce antibodies capable of fighting unfamiliar red blood cells. Such antibodies, penetrating into the developing organism, begin a vigorous activity aimed at the destruction of blood cells alien to the maternal organism.
Such deviations are present in the Rhesus conflict. But even with different Rhesus, it does not always occur in the fetus and mother.
First of all, during the first pregnancy maternal leukocytes with unfamiliar antigens face for the first time. Therefore, the production of antibodies occurs rather slowly, and may not even begin. Here, on hand weak maternal immunity. It is the slowness of the white blood particles can save from the occurrence of Rh-conflict.
But during repeated pregnancy In a woman's body, cells of “memory” are preserved, which causes an increased formation of antibodies.
The organism remembers alien particles not only after previous genera. An immune memory capable of recognizing positive blood antigens is present after:
• miscarriage;
• positive blood transfusions;
• medical abortion;
• ectopic pregnancy.
Even if all adverse factors coincided, and Rh-conflict is inevitable, medicine provides effective methods that can correct the situation.
Methods for diagnosing possible problems with negative Rh factor during pregnancy
Rh factor is determined by a woman at the very beginning of pregnancy. It is good if future parents found out blood counts even when planning a pregnancy.
If the negative Rh factor of the woman is confirmed, it is put on a special account. Father, too, will have to donate venous blood to know the likelihood of Rhesus conflict.
For women who have a negative Rh factor during pregnancy, it is extremely important to regularly monitor blood counts. The antibodies detected in the blood in time will prevent negative consequences.
Therefore, pregnant women from the risk group 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 conduct routine ultrasound examinations. The doctor, first of all, pays attention to the condition of the spleen and liver of the baby, as well as the condition of the placenta. If deviations are found, it may be necessary:
• cardiotocography, which will help to monitor the fetal heart rhythm, determine the probability of hypoxia,
• doplerometry - allows you to know the speed of blood flow in the placenta and the fetus, as well as to assess the condition of the heart.
Invasive methods for 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, appearance of hematomas on the umbilical cord, infections in the amniotic fluid, placental abruption.
But these are the most informative survey methods:
1. In case of amniocentesis, an analysis of amniotic fluid is taken, which is taken through a puncture of the membranes of the fetus. This method allows you to determine the amount of bilirubin.
2. At cordocenosis, blood is collected from the fetus through the umbilical cord. With the help of this survey will find out all indicators of the baby’s blood condition.
What to do if deviations are revealed in case of a negative Rh factor during pregnancy?
If the examination revealed antibodies, and their number increases, it is recommended for the woman to be under constant observation in the perinatal center. Doctors in this case will be able to determine in time the degree of threat and take appropriate measures.
The only way to curb the activated leukocytes in the blood and to neutralize the mother’s formed antibodies is to administer antiresus immunoglobulin. After injection, the blood is quickly cleared of "particle-aggressors." Immunoglobulin injection is resorted to at 28 weeks. But there are situations when the injection may be needed in earlier periods.
When a serious abnormality occurs in the fetus, it is resorted to the introduction of negative rhesus blood through the umbilical cord. The procedure is carried out under the control of the fetus using ultrasound.
If there is a threat of hemolytic disease, artificial maintenance of the fetus may be necessary. This allows you to protect the child from the biological exchange with the mother.
How negative is the Rh factor during pregnancy dangerous for an unborn baby?
The fetus, losing its own red blood cells in significant quantities, is independently unable to combat this phenomenon. The activity of maternal antibodies triggers irreversible pathological processes:
1. Red blood cells are primarily responsible for the delivery of oxygen. Reducing their number leads to oxygen starvation of the fetus, which significantly affects the development. First of all, the brain and heart suffer. 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 appeared in the child’s body as a result of the destruction of red blood cells, causes intoxication. The child’s brain suffers 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 disabilities.
4. Faced with an imbalance in the blood, the system of synthesis of blood particles, for which the spinal cord is responsible, may be disrupted. Such a pathology is fraught with hemolytic anemia of congenital nature.
After the birth of 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. Depressions and hypotension may occur.
They may have jaundice, which is associated with an increased level of bilirubin. Bilirubin in large quantities can be observed during the first years of life, which increases the load on the liver, kidneys, heart and brain. Therefore, serious loads are contraindicated for such children. They have a predisposition to hepatitis.
Only 0.2% of babies have congenital pathologies associated with immune disruptions.
Specificity of childbirth with negative Rh factor during pregnancy
If the pregnancy, despite the negative Rh factor, proceeded without deviations, the birth proceeds naturally. It must be borne in mind that with increased blood loss during labor, the activity of leukocytes can be activated and increased production of antibodies can begin. Therefore, during childbirth with a negative rhesus, a portion of negative rhesus blood must always be prepared. If necessary, an immunoglobulin injection can be made during delivery.
If the pregnancy with a negative Rh factor of the mother was accompanied by Rh conflict, a cesarean section is performed. The operation is planned for 38 weeks, if it is possible to bring the problematic 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 first days is carried out by non-mother's milk. It still contains antibodies that, once in the baby’s body, will begin to destroy its red blood cells.
In addition, a woman within 72 hours after birth, it is necessary to make an injection of anti-rhesus immunoglobulin. This will avoid problems with subsequent pregnancies. The same injection is carried out after a miscarriage or abortion. But it is necessary to keep within three days.
Even if the first pregnancy and childbirth with a negative Rh factor passed without complications, during subsequent pregnancy memory cells are sure to work.
Therefore, if a subsequent pregnancy is planned from a "positive" man, it is better to know in advance about the availability of funds in the maternity hospital. It is advisable to purchase such an injection yourself.
Remember, incompatibility of the Rh factor with your beloved man is not a reason to refuse the happiness of motherhood. The problem of rhesus-conflict occurs only in 10% of women with negative rhesus during pregnancy, and children with serious pathologies are born only in 2-3 cases out of a thousand problematic pregnancies.
