Coincidence of Rh factors. Pregnancy with different Rh blood factors

When planning a pregnancy, a married couple needs to undergo certain examinations. At the same time, it is important to find out the compatibility of blood groups for conceiving a child, because this will avoid many complications during pregnancy and ensure the healthy development of the baby.

You can take a special test to determine your parents’ blood group and Rh factor in any clinic. The results will help the gynecologist make the right prescriptions during the gestation period in order to minimize the possible influence of different Rh factors of the parents on the baby.

The blood group division system is based on specific sets of proteins A and B. Genetics define them as alpha and beta agglutinogens.

Group 1 – no alpha and beta agglutinogens

Group 2 – alpha agglutinogens are present

Group 3 - beta agglutinogens are present

Group 4 – alpha and beta agglutinogens are present

You also need to find out the value of the Rh factor, since it is it that affects the compatibility of blood for conception. There are Rh factor negative and positive. In the event that human red blood cells contain specific proteins and antigens, it is diagnosed Rh positive. If they are absent, it is negative.

There is an opinion that women in the first group do not experience problems with pregnancy and they give birth to healthy babies. Such people are the best donors, because this blood group has excellent compatibility with all others (in the case of a Rh match). It is believed that these people prefer to eat meat products. There is an opinion that people with blood type II prefer vegetable and fruit dishes. And on the third, they prefer flour.

Myths about compatibility

There is a blood group compatibility table for conceiving a child floating around the Internet.

Allegedly, women with the first blood group are incompatible with men of the second, third and fourth. Women with the second - with men who have the third or fourth group, etc. There is another opinion: if the spouses have the same blood type, then conception is unlikely, or in this case weak children are born.

Obstetricians and gynecologists say: all this is complete nonsense. Such tables have nothing to do with medicine; they are completely invented by unscrupulous “healers” or illiterate authors of articles. The blood of the parents does not affect the conception of the child in any way!

To eliminate any last doubts, conduct a short survey of your own parents, relatives or friends who have children. You will see that babies are born to couples with a very different combination of blood groups: 1 and 2, 2 and 4, 1 and 4, and so on.

In some rare cases, a woman cannot become pregnant due to so-called immunological incompatibility. A man's seminal fluid contains certain components that are rejected by the woman's immune system. The partner develops a kind of “allergy” to the man’s sperm. In some articles, this phenomenon is associated specifically with blood type. But blood has nothing to do with it; this phenomenon is of a completely different order. By the way, such incompatibility can be successfully treated.

Rhesus conflict

When parents have the same Rh factor, we can say with confidence that they will have excellent compatibility. Determining compatibility by Rh factor is an important component when planning pregnancy. Having the necessary information and, accordingly, receiving the correct medical treatment, such couples can significantly reduce the risk of spontaneous abortions and avoid problems with the health of the unborn baby.

If the mother has a Rhesus sign with a plus sign, and the father has a Rhesus sign with a minus sign, then this will not affect conception in any way. Moreover, geneticists claim that in most cases the baby is also born “positive”. IN in this case we can say that the parents are compatible to conceive a child.

If the situation is the opposite (mother is a minus, father is a plus), then this can lead to certain problems. If a child inherits Rh negative from his mother, then everything will be fine. If the fetus has +, and this is not the first pregnancy, then a conflict is possible.

See table.

The conflict will not affect conception, but it may interfere with the natural development of the fetus or the pregnancy may end in spontaneous abortion.

The female body perceives the baby as something foreign that needs to be gotten rid of. The active confrontation between the mother's particles and the protein in the baby's cells leads to a conflict that significantly affects the condition of the fetus. And pregnancy is accompanied by such unpleasant complications as severe toxicosis, general weakness and severe fatigue.

Pregnancy and Rhesus

Even if a woman is Rh negative and a man is Rh positive, conflict usually does not occur during the first conception, since the mother’s body has not yet developed antibodies to foreign proteins. Therefore, it is especially dangerous for women with Rh negative to have an abortion if she is pregnant for the first time.

But subsequent pregnancy due to the effects of antibodies, as a rule, causes certain difficulties. The following maternal diseases provoke an increase in the number of antigens:

• Preeclampsia;
• Diabetes;
• Increased uterine tone.

The result of such a conflict can be anemia, jaundice, and dropsy in the baby. However, this does not mean that such married couples have no chance of giving birth. If all the recommendations of the attending physician are followed, a healthy child will be born.

• Find out the baby’s Rh factor using a chorionic villus biopsy;
• Periodically destroy antibodies by administering immunoglobulin;
• If necessary, perform a puncture of the fetal umbilical cord;
• Prescription of anti-allergy drugs and vitamin complexes;
• If a danger to the life of the mother or child is predicted, induce labor.

The best way out in this situation would be to register with a gynecologist long before planning a pregnancy if you want a second child. In this case, the woman will be prescribed anti-Rhesus immunoglobulin, which will significantly reduce the risk of possible complications.

What group will the child have?

Parents are also interested in what group and Rhesus their baby will have. Will they inherit the blood characteristics of mom or dad or will their indicators be different? Geneticists say that children inherit blood parameters in the same way as other characteristics.

If mom and dad are the owners of the first blood group, then their baby will also not have the antigen in the blood;

Parents with the first and second groups will pass on their groups to their offspring;

If the spouses are owners of the fourth group, then their child can be born with any indicator except the first;

The presence of parents of groups 2 and 3 makes it possible for a baby to be born with any of the four possible groups.

As for the Rh factor, everything is much simpler here. The presence of negative indicators in the parents indicates that the child will be born with the same sign. If mom and dad have different Rhesus values, then the baby can have both positive and negative Rhesus.

Competently: an obstetrician-gynecologist answers questions

Our consultant is obstetrician-gynecologist Elena Artemyeva.

- I have 1 positive group blood, and the spouse has 1 negative. Is this bad for our unborn child?

- No. This difference will not have any effect on either conception or pregnancy.

“Both my husband and I have the third group, Rh positive. I heard that this is bad for conception.

— Blood type does not affect conception in any way.

- I can't get pregnant. Could this be due to the fact that my husband and I have the same blood type (2) and the same Rh factor (+).

- No, he can not. Look for the cause in the state of reproductive health, you need to be examined.

- If I have 1 negative and my husband has the same, is this bad for the unborn child?

- No, in your case there will be no Rh conflict, since the child will have a negative Rh factor.

— I am Rh negative, my husband is positive. The first child was born healthy. During the second pregnancy, doctors did not detect the conflict in time, and the child died. What should I do now to ensure that my third pregnancy goes well?

— You need to prepare for such a pregnancy in advance. One option is to “cleanse” the blood of existing antibodies (for example, using plasmapheresis) so that the risk is minimal. During pregnancy, antibodies to the Rh factor should be monitored monthly. As soon as signs of sensitization appear, plasmapheresis is performed.

Another option is to go eco. In this case, Rh-negative embryos are identified and implanted.

— My blood is negative, my husband’s is positive. This is my first pregnancy and is going well. Is it necessary to give immunoglobulin after childbirth so that there is no conflict during the next pregnancy?

- Yes, this must be done in the first 72 hours after birth.

Rh factor is a protein that is found on the surface of red blood cells. Such indicators as positive and negative Rh factor depend on its presence. It cannot change and affect metabolism, immune system or the person's health status.

The Rh factor is a genetic feature of a person.

Rh factor is an antigen that is found on the surface of red blood cells. 85% of people have a positive Rh factor. In the rest of the group of people it is negative. The Rh factor has absolutely no effect on a person's life.

The exception is pregnant women who have a negative Rh factor. If the test is positive, the father of the child may have a conflict antigen.

During pregnancy, the Rh factor of the fetus overcomes the mother's placental barrier. In turn, the mother’s body begins to recognize the child as foreign. This leads to the production of protective antibodies. When protecting a woman, it is observed for her child. If the conflict antigen is severe, it can lead to the death of the baby. A miscarriage in a representative of the fairer sex can be observed at different terms pregnancy.

Antibodies from the mother penetrate the placenta and destroy the red blood cells of the fetus. As a result, large quantities of bilirubin appear in the blood. It dyes the baby's skin in yellow. As a result of the conflicting antigen, rapid destruction of red blood cells is observed. The liver and spleen produce them intensively, which leads to the appearance of a conflict antigen.

The Rh factor is sufficient important aspect in bearing a child, which must be taken into account when...

Conception and Rh factor

When conceiving a child, it is imperative to take into account the Rh factor of the father and mother. If the father is Rh positive, it is often passed on to the child. When the mother's Rh factor is negative, a conflict antigen often arises between her and the child. Since antigen transmission is carried out only by hereditary means, the threat of Rh conflict can only appear in the case described above.

Many couples are very worried about this when planning a pregnancy. Some do not even start a family when such a situation arises. But you shouldn't do this. In most cases, among representatives of the fairer sex, the first course proceeds normally. If a woman has not previously had experience with a positive factor, then her body is characterized by the absence of antibodies. That is why a conflict antigen cannot arise. Also, during the first pregnancy, antibodies are produced in small quantities, which significantly reduces the risk of conflict.

After a representative of the fairer sex bears her first child, the memory of a positive Rh factor will remain in her body. During subsequent pregnancies, the woman will intensively produce antibodies, which will lead to the death of the fetus. The result of Rh-incompatible pregnancy plays a fairly important role.

The appearance of a conflict antigen is directly affected by the number of red blood cells that enter a woman’s bloodstream during pregnancy.

If antibodies are detected in a pregnant woman, which rapidly increase in quantitative ratio, one can judge that a conflict antigen has begun. In this case, the fairer sex is sent to a specialized perinatal center to undergo a course of treatment. In this case, constant monitoring of the condition of the woman and fetus is recommended.

After the baby is born, its antigen is immediately determined. Upon receipt positive results Within 72 hours, the woman is given anti-Rhesus serum. Its action is aimed at eliminating possible conflicting antigens in subsequent pregnancies.

To avoid the appearance of a conflict antigen, it is imperative to take certain preventive measures:

• A pregnant woman needs to undergo antigen tests. If she was determined to be Rh negative, then they test for the father's Rh factor.
• If there is a risk of a conflicting antigen, repeated blood tests are performed on a representative of the fairer sex. With its help, a woman’s antibodies to fetal red blood cells are determined in quantitative terms.
• Tests are carried out every four weeks during the eight months of pregnancy. After this, tests are carried out once every two weeks or every week.
• The level of antibodies in the blood of a representative of the fairer sex makes it possible to determine the onset of the appearance of a conflict antigen. The test can also determine the Rh factor in a child.
• If a female representative has an ectopic pregnancy, then she also needs serum administration within 72 hours. This procedure is also carried out when artificial interruption pregnancy or
• When transfusion of Rh-positive blood or platelet masses, serum administration is also necessary.
• The procedure for administering the serum is also carried out if a woman’s placenta separates.

The Rh factor does not affect human life. If a pregnant representative of the fairer sex has a negative Rh factor, a conflict antigen may arise. If both parents have the Rh factor, the expectant mother should be under strict medical supervision.

Pregnancy planning includes a set of measures aimed at optimizing conditions for conception and the birth of healthy offspring. It is advisable for future parents to examine the body, give up bad habits, lead a healthy lifestyle, and prepare themselves emotionally.

Doctors recommend determining in advance the blood group and Rh factor. The most important nuance for conceiving a child in marriage is checking the compatibility of the parents by blood type and Rh factor using the tables presented in our article.

Story

Human blood is characterized by one of four groups, distinguished by a set of specific proteins within the red blood cells. Usually, proteins (otherwise known as antigens or agglutinogens) are designated by the letters A and B. Red blood cells of the first blood group do not contain antigens, the bodies of the second include only protein A, the third - B, and the fourth - both of the above proteins.

The age of the first antigenic phenotype is estimated at 60-40 thousand years.

It is most common in areas of South and Central America, which is due to minimal migration and lack of mixed marriages between local residents and representatives of other nations.

The second appeared much later in Asia, approximately 25-15 thousand years ago, a large proportion of carriers lived in Europe and Japan. It is interesting that the number of people of groups I and II prevails and makes up 80% of the population.

The emergence of the third group is regarded by some researchers as a result of evolution that changed the human immune system, while others as the result of a mutation.

The emergence of the fourth group- a mystery for scientists. If we believe the studies of the substance on the Shroud of Turin, in which the body of Jesus Christ was wrapped, he was the owner of this youngest group.

A child inherits a set of proteins from his parents, based on the laws of genetics. To determine the possible combination of antigens of the future baby, we find probable inheritance options at the intersection of the columns of the mother and father groups.

Inheritance during pregnancy

Child blood type inheritance chart.

Thus, mom and dad with the second and third groups give birth to children of any combination of agglutinogens with equal probability. A couple with the first group gives birth to children whose red blood cells lack proteins. The carrier of the fourth group will never give birth to the offspring of the first.

Genetics, like other sciences, is not without exceptions. In a small percentage of people, red blood cells contain silent A and B antigens.

As a result, the baby inherits a set of agglutinogens that is different from the possible one. The paradox is called the “Bombay phenomenon” and affects one in 10 million people.

The baby's circulatory system is formed in the mother's womb. Antigens appear in cells in the early stages of pregnancy (2-3 months).

When a baby inherits a protein from his father that is not in his mother's blood, there are cases of a woman developing antibodies to a protein foreign to her. This process is called a conflict of people according to blood groups or an immunological conflict, in which case their compatibility is in question.

Incompatibility develops in following cases:

• for women group I, for men II, III, IV;
• for women II, for men III, IV;
• III for women, II or IV for men.

The situation is especially dangerous when a woman of the first group is carrying a baby with II or III. This situation often causes complications.

Fortunately, most often incompatibility occurs easily and does not require intensive care. Incompatibility during repeated conception does not entail more unpleasant consequences.

Compatibility table for conception by blood group of husband and wife.

Sometimes a woman's immune system begins to produce antisperm antibodies that kill sperm. Then an absolutely healthy couple faces problems conceiving.

Therefore, competent pregnancy planning involves testing for antisperm antibodies.

Rh of father and mother

In addition to the group, blood is characterized by the presence of another antigen in red blood cells - the Rh factor.

Most people on the planet are carriers of the Rh factor (Rh), they are called Rh-positive.

Only 15 percent of the population does not contain Rh in their red cells; they are Rh negative.

Inheritance of the antigenic phenotype and Rh factor occurs independently of each other.

It is possible to say exactly what Rh factor the child will receive only when both parents are Rh negative.

In other situations, it is impossible to predict Rh, it can be anything.

Table for determining the Rh factor of a child.

Some cases are characterized by immunological incompatibility of the Rh factor between mother and fetus. The conflict manifests itself in a small percentage of the fair sex with negative Rh, if the baby inherited the positive Rh of the father.

The mother's body produces antibodies that attack the baby's red blood cells through the placenta. Unfortunately, the placental barrier provides 100% protection only during an ideal pregnancy, which is very rare. Attacks on an unformed creature destroy the liver, heart, and kidneys.

Pregnancy complicated by Rhesus conflict often ends in miscarriage. When the baby manages to survive, dropsy, jaundice, anemia, and mental health problems are likely.

How does a Leo man behave in love and relationships? We will tell you about the bright representatives of the “fire” sign in this article: .

How to behave in case of Rh conflict

The expectant mother must know her blood type and Rh. Planning to conceive First of all, it is worth taking the appropriate tests(to determine the blood type and Rh factor), because the compatibility of spouses is important for the birth of healthy children, but not required.

Let us note that it is possible to carry and give birth to a healthy, strong child even if there is an immune conflict. The girl needs to be under the supervision of a doctor. If antibodies are detected, treatment is prescribed.

During the pregnancy of the first child, such a conflict appears less frequently, which is due to a number of biological reasons. Risk factors for Rh – negative women are previously suffered miscarriages, abortions,...

Antibodies tend to accumulate This means that the destruction of red blood cells during subsequent pregnancies will begin earlier and, accordingly, will cause more severe consequences.

The most serious complication of the above situation is considered to be hemolytic disease of the newborn. It comes in three forms:

• icteric – the skin turns yellow;
• anemic – jaundice, no edema;
• edematous – accompanied by general edema and jaundice.

Diagnosing incompatibility between mother and fetus start with determining the Rh of the fetus. If the father has Rh-positive blood and the mother has Rh-negative blood, pregnant women have their blood tested for antibodies at least monthly.

Gestation occurs without discomfort, only slight weakness is possible.

Symptoms of incompatibility are detected only by ultrasound examination. When there are more antibodies, and ultrasound shows fetal development abnormalities, do intrauterine blood transfusions.

If the life of the pregnant woman and the fetus is threatened, a decision is made on artificial birth.

The birth of a new life is a great happiness, which is sometimes overshadowed by a doctor’s diagnosis after testing by potential parents. Planning a pregnancy is the most important stage, but not a panacea for unpleasant surprises.

This video contains some more information about why it is so important for parents to get tested to determine their blood type and Rh factor when registering during pregnancy:

Even if you get pregnant unplanned, don't worry. It should be remembered that love conquers all, and timely contact with an experienced specialist and an examination will significantly increase the chance of the baby’s favorable development.

The time of bearing a child is one of the most beautiful times in a woman’s life. Every expectant mother wants to be calm about the baby’s health and enjoy the period of waiting for a new addition. But every tenth woman, according to statistics, has Rh-negative blood, and this fact worries both the pregnant woman herself and the doctors who observe her.

What is the possibility of Rh conflict between mother and baby, and what the danger lies, we will tell you in this article.

What it is?

When a woman and her future toddler have different blood counts, immunological incompatibility may begin; this is what is called Rh conflict. Representatives of humanity who have a Rh factor with a + sign have a specific protein D, which is contained in red blood cells. In a person with rhesus negative value this protein is missing.

Scientists still don't know for sure why some people have the specific Rhesus monkey protein and others don't. But the fact remains that about 15% of the world’s population have nothing in common with macaques; their Rh factor is negative.

There is a constant exchange between the pregnant woman and the child through the uteroplacental blood flow. If the mother has a negative Rh factor, and the baby is positive, then protein D entering her body is nothing more than a foreign protein for the woman.

The mother's immune system very quickly begins to react to the uninvited guest, and when protein concentration reaches high values, Rh conflict begins. This is a merciless war that the pregnant woman’s immune defense declares on the child as the source of a foreign antigen protein.

Immune cells begin to destroy the baby's red blood cells with the help of special antibodies that he produces.

The fetus suffers, the woman experiences sensitization, the consequences can be quite sad, including the death of the baby in the mother’s womb, the death of the baby after birth, or the birth of a disabled child.

A Rh conflict can occur in a pregnant woman with Rh (-), if the baby has inherited her father’s blood characteristics, that is, Rh (+).

Much less often, incompatibility occurs based on such an indicator as blood group, if a man and a woman have different groups. That is, a pregnant woman whose own Rh factor has positive values ​​has nothing to worry about.

There is no reason to worry for families with the same negative Rhesus, but this coincidence does not happen often, because among the 15% of people with “negative” blood, the vast majority are representatives of the fair sex, men with such blood characteristics are only 3%.

Toddlers' own hematopoiesis begins in the womb at approximately 8 weeks of gestation. And from this moment on, in maternal blood tests it is not determined in the laboratory a large number of fetal erythrocytes. It is from this period that the possibility of Rh conflict arises.

Probability tables

From a genetic point of view, the probability of inheriting the main characteristics of blood - type and Rh factor from father or mother is estimated at 50%.

There are tables that allow you to assess the risks of Rh conflict during pregnancy. And timely weighed risks give doctors time to try to minimize the consequences. Unfortunately, medicine cannot eliminate the conflict completely.

By Rh factor

By blood type

Causes of the conflict

The likelihood of developing a Rh conflict greatly depends on how and how the woman’s first pregnancy ended.

Even a “negative” mother can quite safely give birth to a positive baby, since during the first pregnancy the woman’s immune system does not yet have time to develop a killer amount of antibodies to protein D. The main thing is that before pregnancy she is not given a blood transfusion, without taking into account the Rh factor, as sometimes happens in an emergency situations to save lives.

If the first pregnancy ended in miscarriage or abortion, then the likelihood of a Rh conflict during the second pregnancy increases significantly, since the woman’s blood already contains antibodies ready to attack at a very early stage.

In women who underwent a caesarean section during the first birth, the likelihood of conflict during the second pregnancy is 50% higher compared to women who gave birth to their first child naturally.

If the first birth was problematic, the placenta had to be separated manually, and there was bleeding, then the likelihood of sensitization and conflict in a subsequent pregnancy also increases.

Danger to expectant mother With negative Rh factor blood also represent diseases during pregnancy. Influenza, ARVI, gestosis, a history of diabetes can provoke a structural disorder chorionic villi, and the mother’s immunity will begin to produce antibodies that are harmful to the baby.

After childbirth, the antibodies that were developed during pregnancy do not disappear. They represent long-term memory of the immune system. After the second pregnancy and childbirth, the number of antibodies becomes even greater, as well as after the third and subsequent ones.

Danger

The antibodies that maternal immunity produces are very small in size; they can easily penetrate the placenta into the baby’s bloodstream. Once in the baby's blood, the mother's protective cells begin to inhibit the fetal hematopoietic function.

The child suffers and experiences oxygen deficiency, since decaying red blood cells are the carriers of this vital gas.

In addition to hypoxia, hemolytic disease of the fetus may develop, and subsequently the newborn. It is accompanied by severe anemia. The fetus's internal organs enlarge - liver, spleen, brain, heart and kidneys. The central nervous system is affected by bilirubin, which is formed during the breakdown of red blood cells and is toxic.

If doctors do not take measures in time, the baby may die in utero, be born still, or be born with severe damage to the liver, central nervous system, and kidneys. Sometimes these lesions turn out to be incompatible with life, sometimes they lead to profound lifelong disability.

Diagnosis and symptoms

The woman herself cannot feel the symptoms of a developing conflict between her immunity and the blood of the fetus. There are no symptoms by which the expectant mother could guess the destructive process that is taking place inside her. However, laboratory diagnostics can detect and track the dynamics of the conflict at any time.

To do this, a pregnant woman with Rh-negative blood, regardless of the blood group and Rh factor of the father, takes a blood test from a vein to determine the content of antibodies in it. The analysis is done several times during pregnancy, the period from 20 to 31 weeks of pregnancy is considered especially dangerous.

The resulting laboratory research, antibody titer. The doctor also takes into account the degree of maturity of the fetus, because the older the baby is in the womb, the easier it is for him to resist an immune attack.

Thus, titer 1:4 or 1:8 at 12 weeks of pregnancy is a very alarming indicator, and a similar antibody titer at 32 weeks will not cause panic in the doctor.

When a titer is detected, the analysis is done more often to monitor its dynamics. In a severe conflict, the titer increases rapidly - 1:8 can turn into 1:16 or 1:32 in just a week or two.

A woman with antibody titers in her blood will have to visit the office more often ultrasound diagnostics. Using an ultrasound, it will be possible to monitor the development of the child; this research method provides fairly detailed information about whether the child has hemolytic disease, and even about what form it has.

In the case of an edematous form of hemolytic disease of the fetus, an ultrasound will reveal an increase in size in the child. internal organs and brain, the placenta thickens, the amount amniotic fluid also increases and exceeds normal values.

If the expected weight of the fetus is 2 times higher than normal, this is warning sign - hydrops of the fetus is not excluded, which can lead to death in the mother’s womb.

Hemolytic disease of the fetus associated with anemia cannot be seen on ultrasound, but can be diagnosed indirectly on CTG, since the number of fetal movements and their nature will indicate the presence of hypoxia.

Damages to the central nervous system will become known only after the birth of the child; this form of hemolytic disease of the fetus can lead to developmental delays in the baby and hearing loss.

Diagnostics doctors in antenatal clinic will be dealt with from the very first day of registration of women with a negative Rh factor. They will take into account how many pregnancies there were, how they ended, and whether children with hemolytic disease have already been born. All this will allow the doctor to guess possible probability the occurrence of a conflict and predict its severity.

During the first pregnancy, a woman will have to donate blood once every 2 months, during the second and subsequent ones - once a month. After the 32nd week of pregnancy, the analysis will be done once every 2 weeks, and from the 35th week - every week.

If an antibody titer appears, which can occur at any time after 8 weeks, additional research methods may be prescribed.

In case of a high titer that threatens the life of the child, a cordocentesis or amniocentesis procedure may be prescribed. The procedures are carried out under ultrasound control.

During amniocentesis, an injection is made with a special needle and a certain amount of amniotic fluid is taken for analysis.

During cordocentesis, blood is taken from the umbilical cord.

These tests make it possible to judge what blood type and Rh factor is inherited by the baby, how severely his red blood cells are affected, what is the level of bilirubin in the blood, hemoglobin, and with 100% probability determine the sex of the child.

These invasive procedures are voluntary and the woman is not forced to undergo them. Despite the current level of development of medical technologies, interventions such as cordocentesis and amniocentesis can still cause miscarriage or premature birth, as well as the death or infection of a child.

The obstetrician-gynecologist who is managing her pregnancy will tell the woman about all the risks when performing procedures or refusing them.

Possible consequences and forms

Rhesus conflict is dangerous both during the period of bearing a baby and after its birth. The disease with which such children are born is called hemolytic disease of the newborn (HDN). Moreover, its severity will depend on the amount of antibodies that attacked the baby’s blood cells during pregnancy.

This disease is considered severe; it is always accompanied by the breakdown of blood cells, which continues after birth, edema, jaundice skin, severe bilirubin intoxication.

Edema

The most severe form of HDN is the edematous form. With it, the little one is born very pale, as if “bloated”, swollen, with multiple internal edema. Such babies, unfortunately, in most cases are born dead or die, despite all the efforts of resuscitators and neonatologists, die in as soon as possible from several hours to several days.

Jaundice

The icteric form of the disease is considered more favorable. Such babies, a couple of days after their birth, “acquire” a rich yellowish skin color, and such jaundice has nothing in common with the common physiological jaundice of newborns.

The baby's liver and spleen are slightly enlarged, and blood tests show anemia. The level of bilirubin in the blood increases rapidly. If doctors fail to stop this process, the disease can develop into kernicterus.

Nuclear

The nuclear variety of HDN is characterized by lesions of the central nervous system. The newborn may experience convulsions and may involuntarily move his eyes. The tone of all muscles is reduced, the child is very weak.

When bilirubin is deposited in the kidneys, a so-called bilirubin infarction occurs. A greatly enlarged liver cannot normally perform the functions assigned to it by nature.

Forecast

Doctors are always very careful when making predictions for TTH, since it is almost impossible to predict how damage to the nervous system and brain will affect the development of the baby in the future.

Children undergo detoxification infusions in intensive care conditions; very often there is a need for a replacement transfusion of blood or donor plasma. If on the 5th-7th day the child does not die from paralysis of the respiratory center, then the forecasts change to more positive ones, although they are rather conditional.

After suffering from hemolytic disease of newborns, children suck poorly and sluggishly, they have decreased appetite, disturbed sleep, and have neurological abnormalities.

Quite often (but not always) such children experience significant mental and mental retardation. intellectual development, they get sick more often, and hearing and vision impairment may occur. Cases of anemic hemolytic disease end most successfully; after the level of hemoglobin in the baby’s blood can be raised, it develops quite normally.

A conflict that has developed not because of a difference in Rh factors, but because of a difference in blood groups, proceeds more easily and usually does not have such destructive consequences. However, even with such incompatibility, there is a 2% chance that the baby will develop quite serious disorders of the central nervous system after birth.

The consequences of the conflict for the mother are minimal. She will not be able to feel the presence of antibodies; difficulties can arise only during the next pregnancy.

Treatment

If a pregnant woman has a positive antibody titer in her blood, this is not a reason for panic, but a reason for starting therapy and taking it seriously on the part of the pregnant woman.

It is impossible to save a woman and her baby from such a phenomenon as incompatibility. But medicine can minimize the risks and consequences of the influence of maternal antibodies on the baby.

Three times during pregnancy, even if antibodies do not appear during pregnancy, the woman is prescribed courses of treatment. At 10-12 weeks, at 22-23 weeks and at 32 weeks, the expectant mother is recommended to take vitamins, iron supplements, calcium supplements, drugs that improve metabolism, and oxygen therapy.

If titers are not detected before 36 weeks of gestation, or they are low, and the development of the child does not cause concern to the doctor, then the woman is allowed to give birth naturally on her own.

If the titres are high and the child’s condition is serious, then delivery can be carried out ahead of schedule by caesarean section. Doctors try to support a pregnant woman with medications until the 37th week of pregnancy, so that the baby has the opportunity to “mature.”

Unfortunately, this possibility is not always available. Sometimes you have to decide on an earlier caesarean section in order to save the baby’s life.

In some cases, when the baby is clearly not yet ready to come into this world, but remaining in the mother’s womb is very dangerous for him, an intrauterine blood transfusion is performed to the fetus. All these actions are performed under the control of an ultrasound scanner; every movement of the hematologist is verified so as not to harm the baby.

In the early stages, other methods of preventing complications can be used. So, there is a technique for suturing a pregnant woman with a piece of her husband’s skin. The skin flap is usually implanted on the lateral surface of the chest.

While the woman’s immune system is putting all its effort into rejecting the foreign skin fragment (which takes several weeks), the immunological load on the child is somewhat reduced. Scientific debate continues about the effectiveness of this method, but reviews from women who have undergone such procedures are quite positive.

In the second half of pregnancy, if a conflict has been established, the expectant mother may be prescribed plasmapheresis sessions, this will slightly reduce the number and concentration of antibodies in the mother’s body, and accordingly, the negative load on the baby will also temporarily decrease.

Plasmapheresis should not frighten a pregnant woman; there are not many contraindications to it. Firstly, it is ARVI or another infection in acute stage, and, secondly, the threat of miscarriage or premature birth.

There will be about 20 sessions. Approximately 4 liters of plasma are purified in one procedure. Along with the infusion of donor plasma, protein preparations are administered, which are necessary for both mother and baby.

For babies who have suffered hemolytic disease, regular examinations by a neurologist and massage courses in the first months after birth are recommended to improve muscle tone, as well as vitamin therapy courses.

Prevention

A pregnant woman is given a kind of vaccination at 28 and 32 weeks - they are given anti-Rhesus immunoglobulin. The same drug must be administered to a woman in labor after childbirth no later than 48-72 hours after the birth of the baby. This reduces the likelihood of developing conflict in subsequent pregnancies to 10-20%.

If a girl has a negative Rh factor, she should know about the consequences of an abortion during the first pregnancy. It is desirable for such representatives of the fair sex save the first pregnancy at any cost.

Blood transfusion without taking into account the Rh affiliation of the donor and recipient is not permissible, especially if the recipient has his own Rh with a “-” sign. If such a transfusion occurs, the woman should be given anti-Rhesus immunoglobulin as soon as possible.

A complete guarantee that there will be no conflict can only be given by a Rh-negative man, preferably with the same blood type as his chosen one. But if this is not possible, you should not postpone pregnancy or refuse it just because the man and woman have different blood. In such families, planning a future pregnancy plays an important role.

A woman who wants to become a mother needs, even before the onset of “ interesting situation» undergo blood tests to detect antibodies to protein D. If antibodies are detected, this does not mean that the pregnancy will have to be terminated or that pregnancy cannot be achieved. Modern medicine does not know how to eliminate conflict, but it knows very well how to minimize its consequences for the child.

The introduction of anti-Rhesus immunoglobulin is important for women who do not yet have antibodies in their blood that are not sensitized. They need to get such an injection after an abortion, after even minor bleeding during pregnancy, for example, with a slight placental abruption, after surgery for ectopic pregnancy. If you already have antibodies, then you shouldn’t expect any special effect from vaccination.

Common Questions

Is it possible to breastfeed a child?

If a woman with Rh negative gives birth to a child with positive Rh factor, and there is no hemolytic disease, then breast-feeding not contraindicated.

Babies who have experienced an immune attack and were born with hemolytic disease of the newborn are not recommended to feed on breast milk for 2 weeks after the administration of immunoglobulin to the mother. In the future, decisions about breastfeeding are made by neonatologists.

In severe hemotylic disease, breastfeeding is not recommended. To suppress lactation, a woman after childbirth is prescribed hormonal drugs, which suppress milk production to prevent mastopathy.

Is it possible to carry a second child without conflict if there was conflict during the first pregnancy?

Can. Provided that the child inherits a negative Rh factor. In this case, there will be no conflict, but antibodies in the mother’s blood can be detected throughout the entire period of gestation, and in a fairly high concentration. They will not affect a baby with Rh (-) in any way, and there is no need to worry about their presence.

Before getting pregnant again, mom and dad should visit a geneticist who will give them comprehensive answers about the likelihood of their future children inheriting a particular blood characteristic.

Dad's Rh factor is unknown

When registering the expectant mother at the antenatal clinic, immediately after identifying her negative rhesus, the father of the future baby is also invited to the consultation to take a blood test. This is the only way the doctor can be sure that he knows exactly the initial data of the mother and father.

If the father’s Rh is unknown, and for some reason it is impossible to invite him to donate blood, if the pregnancy resulted from IVF with donor sperm, then a woman will have her blood tested for antibodies a little more often than other pregnant women with the same blood. This is done in order not to miss the moment of the beginning of a conflict if it occurs.

And the doctor’s offer to invite my husband to donate blood for antibodies is a reason to change the doctor to a more competent specialist. There are no antibodies in the blood of men, since they do not become pregnant and do not have any physical contact with the fetus during their wife’s pregnancy.

Is there an impact on fertility?

There is no such connection. The presence of negative Rh does not mean that it will be difficult for a woman to get pregnant.

Fertility levels are influenced by completely different factors - bad habits, caffeine abuse, excess weight and diseases of the genitourinary system, aggravated medical history, including a large number of abortions in the past.

Are medication or vacuum abortion safe for terminating a first pregnancy in an Rh-negative woman?

This is a common misconception. Moreover, unfortunately, such a statement can often be heard even from medical workers. The method of performing an abortion does not matter. Whatever it is, the baby’s red blood cells still enter the mother’s bloodstream and cause the formation of antibodies.

If the first pregnancy ended in abortion or miscarriage, how great are the risks of conflict in the second pregnancy?

In fact, the magnitude of such risks is a rather relative concept. No one can say with one percent accuracy whether there will be a conflict or not. However, doctors have certain statistics that estimate (approximately) the likelihood of sensitization of the female body after an unsuccessful first pregnancy:

• miscarriage at a short term - +3% to a possible future conflict;
• artificial termination of pregnancy (abortion) – +7% to the probable future conflict;
• ectopic pregnancy and surgery to eliminate it – +1%;
• delivery at term with a live fetus – + 15-20%;
• delivery by cesarean section – + 35-50% to a possible conflict during the next pregnancy.

Thus, if a woman’s first pregnancy ended in abortion, the second in a miscarriage, then while carrying the third, the risk is estimated at approximately 10-11%.

If the same woman decides to give birth to another baby, provided that the first birth went well naturally, then the probability of a problem will be more than 30%, and if the first birth is completed caesarean section, then more than 60%.

Accordingly, any woman with a negative Rh factor who is planning to become a mother again can weigh the risks.

Does the presence of antibodies always mean that a child will be born sick?

No, this doesn't always happen. The child is protected by special filters that are in the placenta; they partially restrain aggressive maternal antibodies.

A small amount of antibodies will not harm the child great harm. But if the placenta ages prematurely, if the amount of water is small, if a woman is sick with an infectious disease (even a common ARVI), if she takes medications without supervision from the attending physician, then the likelihood of a decrease in the protective functions of the placenta filters increases significantly, and the risk of giving birth to a sick baby will increase. .

It should be borne in mind that during the first pregnancy, antibodies, if they appear, have a fairly large molecular structure, it can be difficult for them to “break through” the defense, but with a second pregnancy, the antibodies are smaller, more mobile, fast and “evil”, so the immunological attack becomes more probable.

Everything related to issues of genetics has not yet been studied well enough, and any “surprise” can be obtained from nature.

History knows several cases when a mother with Rh (-) and a father with a similar Rh gave birth to a child with positive blood and hemolytic disease. The situation requires careful study.

For more information about the likelihood of Rh conflict during pregnancy, see the following video.

Many young spouses who have decided to conceive a child are interested in how important parental blood type compatibility is for this purpose.

Blood type compatibility

When planning the birth of a child, parents are required to take into account blood type compatibility in order to avoid complications. When a fetus is born, maternal and paternal blood mixes. This is how the baby's blood is formed. The baby can have any blood type, since at conception four groups are formed simultaneously, but in different percentages. The largest percentage comes from the parents' blood. Therefore, the child will have the blood type of either the father or the mother. When the parents have the same blood type, then in most cases (95-98%) the child will have the same blood type. When parents have different blood types, the baby has a 25% chance of inheriting one of them. Thus, a child can have both I, and II, and III, and IV blood groups. It is believed that the healthier child is the one whose father’s blood type is higher than that of the mother. The higher the blood type of the future dad, the better it is for the baby. Be that as it may, if the parents have the same blood type, pregnancy is safe.

The importance of the Rh factor

According to gynecologists, the blood type of future parents is not as important as their Rh factor; it is desirable that it be the same. So, in order to avoid problems when conceiving and bearing a child, it is important that both partners have the same Rh factor value.

Rh factor- a special protein that is located on the surface of red blood cells: if such a protein is present, then the Rh factor is positive, but if it is not, then the Rh factor is negative.

• If a woman’s blood Rh factor is negative, then, ideally, it should also be negative in a man.
• If a woman’s test is positive, then for the benefit of the unborn child, it is desirable that the man’s be positive as well.

Note to expectant mothers and fathers: in 99% of cases, the baby inherits the maternal group and Rh blood. In turn, problems arise at conception, during pregnancy, and even after the birth of the baby if the rhesus of the mother’s blood differs from the rhesus of the father’s blood. In addition, the baby’s inheritance of a non-maternal blood type and Rh factor is fraught with problems. If these values ​​do not coincide for future parents, then before conception it is highly desirable, and sometimes even mandatory, special therapy to prevent rejection of the fetus by the mother’s body. That is why before conceiving a baby (especially before your first pregnancy), you must undergo tests to determine the blood type and Rh factor of the future parents. Thus, the same blood type in future parents is not an obstacle to a healthy pregnancy.