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Most of us have hardly ever thought about what the Rh factor is. This is not surprising: after all, in ordinary life, its presence or absence does not entail any painful consequences. This question becomes relevant only when it comes to pregnancy...

The Rh factor is a protein (or Rh antigen) that is located on the surface of erythrocytes - human red blood cells. It was first identified in rhesus monkeys, which is where it got its name. Scientists managed to discover the Rh factor about 70 years ago. Their discovery helped determine that some people have this very Rh factor and, accordingly, are Rh positive. In another part of humanity, the Rh factor was not detected; such people are considered Rh negative.

The Rh factor is inherited as a strong, dominant trait. That is why most (about 85%) people have it. The blood of these people is Rh positive. The remaining 15% do not have it - they have Rh-negative blood. Thus, Rh-positive blood means the presence of Rh protein (or Rh factor), and Rh-negative blood means the absence of this factor.

A negative Rh factor is not felt in any way by a person in everyday life. However, during pregnancy, a discrepancy between the Rhesus affiliation of the mother and the fetus can cause the so-called Rhesus conflict.

Conflict: who is to blame?

Rh sensitization (Rh conflict) is the production in the body of a Rh-negative mother of antibodies to the antigens of the Rh system of the fetus, that is, to a protein located on the child’s red blood cells.

A problem can only arise when the expectant mother is Rh negative, that is, there is no Rh factor in her blood, and the future father is Rh positive (the Rh factor is detected in his blood), then the baby can inherit Rh from him - accessory. Thus, the baby, like his dad, will be Rh-positive (the Rh factor will form in his blood). The formation of the baby's Rh status is completed by the 8th week of pregnancy.

It turns out that the expectant mother is carrying her baby, who differs from her in the presence of the Rh factor in her blood, while she herself does not have this Rh factor. The mother's immune system recognizes the foreign protein - the baby's Rh factor - and begins to fight it. The fight against the “enemy” is carried out as follows: the mother’s body secretes Rh antibodies, which begin to attack the red blood cells of the fetus.

The results of this struggle may be very disastrous. Red blood cells (erythrocytes) in the fetal blood are destroyed and die. As a result, the baby’s total number of red blood cells decreases and he develops anemia (anemia). As the fetal red blood cells break down, they release bilirubin, a substance that is a toxin for the baby. Circulating in the baby’s blood, bilirubin poisons it and paralyzes the functioning of the vital organs of the child’s body. This condition is called hemolytic disease of the fetus. Without specific and timely treatment, the fetus may die, so suspicion of the development of Rh conflict is an indication for hospitalization in a specialized clinic.

It is important to understand that such serious pregnancy complications as Rh conflict and hemolytic disease of the baby occur only in one case - if the unborn baby has an Rh negative mother and an Rh positive father. But even with an Rh-positive dad, it is very possible (up to 50% probability) that the baby will be Rh-negative, like his mother, and he will not face any complications!

In all other cases:

  • father and mother are Rh positive,
  • father and mother are Rh negative,
  • the father is Rh negative, the mother is Rh positive - the development of Rh conflict and hemolytic disease of the fetus is impossible.

It must be said that even if a Rh-positive child develops, a Rh-negative mother will not necessarily develop a Rh conflict, that is, in this case, antibodies to the fetal red blood cells will not always form in the mother’s body. For an Rh negative woman who becomes pregnant for the first time in her life, the risk of developing an Rh conflict is only 10%. In the absence of complications (antibody formation) in the first pregnancy, the same degree of risk (10%) remains in the next pregnancy.

Even if Rh antibodies are found in the blood of a pregnant woman, this does not mean a 100% risk of disease in the fetus, because the baby has so many protectors. There are special biological filters in the blood of the expectant mother, in the waters surrounding the baby, and, of course, in the main organ of pregnancy - the placenta. These filters block Rh antibodies, trapping them and preventing them from passing further to the baby. However, the effectiveness of such protection largely depends on the general health of the expectant mother and the course of pregnancy. Unfortunately, chronic diseases of a pregnant woman (primarily infections) and complications of pregnancy (toxicosis, partial) reduce the effectiveness of protection and increase the risk of developing Rh conflict. Normally, during pregnancy, a small amount of fetal blood enters the mother’s bloodstream, insufficient for sensitization, however, in the presence of bleeding, arterial hypertension, during obstetric manipulations and intrauterine interventions, the volume of fetal blood entering the woman’s bloodstream increases. Thus, carrying out invasive studies during pregnancy (techniques including micropuncture and sampling of fetal cells, umbilical cord, placenta, fetal fluid) increases the risk of developing Rh conflict and hemolytic disease of the fetus. Also, a large volume of blood enters a woman’s bloodstream during an artificial or spontaneous abortion and caesarean section.

Rh antibodies in a woman whose blood does not have the Rh factor can be formed during pregnancy termination: spontaneous abortion (miscarriage), medical abortion and during development. The incidence of antibodies in various types of abortion is about 3%. These antibodies circulate in a woman’s blood throughout her life and can cause Rh conflict during the next pregnancy, even after many years. As a result, the next pregnancy may end in hemolytic disease of the fetus or miscarriage.

All expectant mothers should remember the importance of maintaining their first pregnancy with a negative Rh factor. When considering whether to terminate your first pregnancy, think about the possible complications, the severity of hemolytic disease, the complexity of its treatment, and in subsequent pregnancies, the high risk of childlessness! Perhaps this will be a strong argument in favor of continuing the pregnancy, will help maintain the health of the unborn baby and will give you happiness.

Prevention of Rhesus conflict

When planning a pregnancy, you should, among other things, establish your blood type and Rh status. In the case where the Rh factor is not detected (that is, the expectant mother is Rh negative), it is necessary to establish the Rh factor of the future father. In any case, you should register no later than 7-8 weeks of pregnancy - this allows you to begin a timely examination of the expectant mother and prevent the development of many complications.

Immediately after registration at the antenatal clinic, the Rh-negative expectant mother will be prescribed a special blood test. This is an analysis to detect Rh antibodies in her blood and their quantity, or antibody titer. If antibodies are not detected, the next time the blood is tested for antibodies is at 18-20 weeks, then monthly. In the absence of Rh antibodies and the successful development of pregnancy at 28 weeks, the woman is given a special drug that prevents the production of antibodies in the blood of the Rh-negative mother. This drug is called anti-Rhesus immunoglobulin. After administration of the drug, the blood is no longer tested for antibodies.

If antibodies are detected or the pregnancy is repeated, anti-Rhesus immunoglobulin was not administered after the completion of previous pregnancies, miscarriages or medical abortions occurred, or Rh-positive children were born - regular determination of antibodies is carried out monthly until the 32nd week of pregnancy. From the 32nd to the 35th week of pregnancy, this test is performed twice, and after the 35th week, the blood is checked for antibodies once a week - until birth. When antibodies appear, their titer is determined.

If Rh antibodies are detected at any stage of pregnancy, the expectant mother is sent for examination to a clinic specializing in the problem of Rh conflict. If antibodies are not detected, the pregnant woman continues to be observed in a regular antenatal clinic, regularly repeating the antibody test.

After the baby is born and the umbilical cord is cut, cord blood is taken directly in the delivery room to determine the baby’s Rh factor. If the newborn, like his mother, turns out to be Rh negative, there is no risk of developing hemolytic disease. If the baby inherits positive Rh from the father, the parent is given another dose of immunoglobulin. This ensures the prevention of Rh conflict in the next pregnancy. The drug needed for this procedure is administered within 48 hours after birth. This drug should be in all maternity hospitals; it is administered to all Rh-negative women in whom no antibodies were detected at the time of delivery. But if you know that you will probably need immunoglobulin, then it is better to ask in advance whether the drug is available in the maternity hospital where you are going to give birth. After giving birth, you need to ask what Rh factor your baby has, and if it is positive, then whether you were given immunoglobulin. It is better if this is done in the maternity unit, in the first 2 hours after birth.

A Rh-negative woman without sensitization symptoms (detection of antibodies indicating the occurrence of a Rh conflict) can give birth in an ordinary maternity hospital that does not specialize in the management of pregnancy and childbirth.

How to overcome hemolytic disease?

If hemolytic disease of the fetus is detected (an increase in the number of antibodies in the blood), the pregnant woman is hospitalized in the pathology department of a specialized maternity hospital. An additional examination is carried out in the maternity hospital. The condition of the fetus is assessed using ultrasound, Doppler and cardiotocography. These studies also help in identifying the first signs of Rh conflict. As a result of the beginning attack of maternal antibodies, the placenta thickens, the amount of amniotic fluid increases, and the baby’s liver and spleen increase in size. Such manifestations of Rh conflict are easily detected using ultrasound.

If indicated, an intrauterine blood transfusion is performed to the fetus.

Two other studies - Doppler and CTG - allow for a functional assessment of the baby’s condition, in other words, to monitor his well-being. Doppler examination is a type of ultrasound that determines the level of blood flow in the uterine arteries, vessels of the placenta and umbilical cord. Its growth and development depend on the blood circulation between mother and baby, because with the blood the fetus receives oxygen and nutrients. With the development of Rh conflict, placental blood flow worsens.

CTG, or fetal cardiac monitoring, is a hardware test that allows you to monitor and record the fetal heart rate (HR) on a special tape. A baby's heart sounds are the main indicator of his well-being. An increase or decrease in heart rate can indicate a general deterioration in the well-being of the fetus.

If there are indications (a rapid increase in the number of antibodies, significant suffering of the fetus), cordocentesis is performed - inserting a needle into the vessels of the baby’s umbilical cord and intrauterine blood transfusion to the fetus.

The procedure is performed as follows: under ultrasound control, a catheter is used to penetrate the umbilical cord vein through the mother's anterior abdominal wall and transfuse 20 to 50 ml of group I donor Rh-negative blood into the fetus. This measure helps to weaken the immune response of the expectant mother’s body. This effect can be achieved by reducing the relative number of Rh-positive red blood cells. Thanks to this, the baby’s condition improves and the pregnancy develops safely. Intrauterine transfusions can be performed repeatedly until the 34th week of pregnancy. After this period, the fetus is considered viable and, if necessary, the issue of early delivery is resolved.


The following methods are also used to treat hemolytic disease of the fetus:

Plasmapheresis- method of blood purification. With plasmapheresis, toxins and pathological products are removed from plasma (the liquid part of the blood). To do this, blood is first drawn and then returned through a plasma filter.

Plasma immunosorption- the method is based on charged molecules of harmful products contained in the blood, which, when passing through a sorbent (activated carbon), “stick” to it. The blood is passed through carbon filters and returned purified.

Skin grafting— a piece of the future father’s skin is “implanted” into the wife for the last 3 months of pregnancy. This is similar to plastic surgery (as, for example, in the treatment of severe burns). When the skin flap of the future father begins to “take root” in a new place, the mother’s body recognizes it as foreign tissue. This is a kind of diversionary maneuver: the pregnant woman’s immunity devotes all its strength to fighting a more foreign agent. The production of antibodies to the baby's Rh is reduced, which makes it possible to prolong pregnancy.

Rh factor (Rh factor) is a blood protein that is found on the surface of blood cells - red blood cells. If this protein is present, then this means that the person has a positive Rh factor, but if it is not there, then it is negative. Rh factor is determined by antigen. There are five main antigens, but it is the D antigen that indicates Rh. 85% of the world's population have positive Rh factors. How to determine your Rh factor? It is enough to donate blood from a vein just once. This indicator does not change throughout life. The Rhesus status of the embryo is formed already in the first trimester of pregnancy. Determining this indicator is very important for the expectant mother, since in the case of an Rh-negative mother and an Rh-positive child, various pregnancy complications are possible. In this case, it will be especially important to follow the doctor’s instructions, avoid infectious and colds, as well as stress. Also on various websites there are so-called calculators that determine the Rh factor of the unborn child.

It must be remembered that blood is donated on an empty stomach. A rapid Rh test can be taken at any independent laboratory where blood is taken (for example, Invitro). The price depends on the price list of the clinic itself. You can find out about the cost of the analysis immediately before delivery. You can also donate blood and find out your Rh factor for free if you become a donor. To do this, you need to fill out a form to register yourself as a blood donor at the appropriate institution.

The Rh factor also plays a big role in blood transfusions. A transfusion involves two people: the recipient (the one who receives the blood) and the donor (the one who donates the blood). If the blood is incompatible, the recipient may experience complications after the transfusion.

The most common myth among couples is that blood type (like the Rh factor) is inherited from a man. In fact, the inheritance of the Rh factor by a child is a rather complex and unpredictable process, and it cannot change during life. But it is worth remembering that in rare cases (about 1% of Europeans) a special type of Rh factor is determined - weakly positive. In this case, Rh is determined either positive or negative. This is where questions arise on forums: “Why did my Rh minus change to plus?”, and legends also appear that this indicator may change. The sensitivity of the testing method plays an important role here.

An equally popular search on the Internet is “horoscope by blood type.” For example, in Japan, great attention is paid to deciphering blood type. Believe it or not - it's up to you.

In the world there is such a thing as a medical tattoo, photos of which can be easily found on the Internet. What do these tattoos mean and what are they for? Its designation is quite pragmatic - in case of a serious injury, when an urgent blood transfusion or surgery is required, and the victim is not able to give the doctor information about his blood type and Rh. Moreover, such tattoos (a simple application of the blood type and Rh factor) should be in places accessible to the doctor - shoulders, chest, arms.

Rh factor and pregnancy

Compatibility of Rh factors during pregnancy- one of the tests that is carried out in the antenatal clinic. When a woman registers with a gynecologist, she will need to donate blood to determine her group and Rh factor. It can significantly affect the course of the next nine months. If the baby inherits a positive Rh from the father, and the mother has a negative Rh, then the protein in the child’s blood is unfamiliar to the mother’s body. The mother's body "considers" the baby's blood a foreign substance and begins to produce antibodies, attacking the baby's blood cells. If there is a Rhesus conflict during pregnancy, the fetus may experience anemia, jaundice, reticulocytosis, erythroblastosis, hydrops fetalis and edematous syndrome of the newborn (in the latter two cases there is a high probability of death of the child).

Blood type and Rh factor: compatibility

The cause of incompatibility may be not only Rh blood type, but also blood type.

What are the different blood types? They are distinguished by the presence of specific proteins.

Four groups:

  • the first (occurs most often) - O - there are no specific proteins in it;
  • the second - A - contains protein A;
  • the third - B - contains protein B;
  • the fourth (the rarest of all) - AB - contains both type A and type B proteins.

First

  • for protein of the second group (A);
  • for protein of the third group (B);

Second(Rh negative) can provoke a conflict in the mother:

  • for protein of the third group (B);
  • for protein of the fourth group (B);
  • for Rh protein (positive).

Third(Rh factor is negative) the mother can provoke a conflict:

  • for protein of the second group (A);
  • for protein of the fourth group (A);
  • for Rh protein (positive).

Fourth does not conflict with any other group.
The only case when an immune reaction is possible is if the mother has group IV and is Rh negative, and the father is positive.

Table 1. Statistics

Blood groups

parents

Possible blood type of the child (probability, %)

Blood type and Rh - pregnancy without complications

Conflict does not arise if the spouses have Rh compatibility. In this case, the child is Rh compatible with the mother’s body: during pregnancy, the mother’s body does not perceive the fetus as a foreign body.

Rh positive during pregnancy

If you are Rh positive, then your husband’s Rh negative will not affect the course of your pregnancy. In the case when a child inherits a negative Rh factor, there is no protein in his blood that is “unfamiliar” to the mother’s immune system, and a conflict will not arise.

  • Rh positive mom + Rh positive dad = Rh positive fetus
    The child has inherited the positive Rh factor of the parents, and the pregnancy will proceed without complications.
  • Rh positive mom + Rh positive dad = Rh negative fetus
    Even if the parents' Rh factor is positive, the baby may be negative. In this case, we can still talk about the compatibility of Rh factors during pregnancy: the mother’s body is “familiar” with all the proteins in the child’s blood.
  • Rh positive mom + Rh negative dad = Rh positive fetus
    It is positive for the mother and the fetus; no conflict arises during pregnancy.
  • Rh positive mom + Rh negative dad = Rh negative fetus
    Although the mother and fetus have different Rh blood factors (mother and child have positive and negative, respectively), there is no conflict.

As already mentioned, Rh blood is a protein. And since the mother’s body already has this protein, the fetal blood does not contain components unfamiliar to the mother’s immune system.

Rh factor negative during pregnancy

Rh negative during pregnancy is not always a death sentence for the baby. The main thing is that it is the same for both the baby and the mother.

  • Rh negative mom + Rh negative dad = Rh negative fetus
    The baby inherited the Rh factor of his parents. And since both the mother and the fetus have no protein (Rhesus) in their blood and their blood is similar, then a conflict does not arise.
  • Rh negative mother + Rh positive father = Rh negative fetus
    This is one of the cases when the Rh factor is very important: the compatibility of the blood of the mother and the fetus affects the next nine months of intrauterine life. Although a woman is Rh negative during pregnancy, it is good that the fetus is also Rh negative. There is no Rh in either the mother's blood or the fetus's blood.

When does Rh-conflict pregnancy occur?

Rh negative mother + Rh positive father = Rh positive fetus
Please note: no matter what group the mother has, negative Rh during pregnancy becomes a cause of conflict. In this case, the embryo inherits it from the father and brings the “new protein” into the body of the Rh-negative mother. Her blood “does not recognize” this substance: there is no such protein in the body. Accordingly, the body begins to defend itself and produce antibodies. They penetrate the placenta into the baby's blood and attack his red blood cells. The fetus tries to defend itself: the spleen and liver begin to work hard, and they increase significantly in size. If a child has few red blood cells left, he develops anemia, or anemia.

What does Rh conflict lead to during pregnancy?

Rh-negative women should monitor their body very carefully and listen to its signals.
This attitude will help prevent:

  • dropsy (fetal edema);
  • anemia;
  • miscarriage;
  • disorders of the child’s brain, speech or hearing.

To protect the baby from these consequences, women with negative Rh during pregnancy must undergo all tests prescribed by the doctor on time.

What to do if you have an Rh conflict pregnancy?

If your chosen one and you have positive and negative Rh factors, respectively, this must be taken into account when planning a pregnancy. Often, Rh conflict does not appear during the first pregnancy, although the parents have different Rh factors. Whatever blood type the expectant mother has (Rh negative) during pregnancy, during the second birth the likelihood of conflict is very high, since her blood most likely already has antibodies.

Rh negative during pregnancy

There is a vaccine - anti-Rhesus immunoglobulin, which prevents Rh-conflict during pregnancy. It binds the antibodies that the mother’s body produces and brings them out. Vaccination can be carried out during pregnancy.

If you are Rh negative and your husband is positive, this is not a reason to give up motherhood. Over the course of 40 weeks, you will have to donate blood from a vein several times:

  • up to 32 weeks - once a month;
  • from the 32nd to the 35th week - 2 times a month;
  • from the 35th to the 40th week - once a week.

If Rh antibodies appear in your blood, your doctor can detect the onset of a Rh conflict in time. In case of conflict pregnancy, immediately after birth, the newborn is given a blood transfusion: the group and Rh factor must be the same as that of the mother. This is especially important in the first 36 hours of the baby’s life - the mother’s antibodies that enter the child’s body are neutralized when they “meet” familiar blood.

When can immunoglobulin prophylaxis be carried out?

To prevent conflict in subsequent pregnancies, women with a negative Rh factor should undergo prophylaxis. This is done after:

  • childbirth (within three days);
  • abortion;
  • analysis of amniotic fluid;
  • spontaneous miscarriage;
  • ectopic pregnancy;
  • placental abruption;
  • transfusion.

Remember: if you and your baby’s group and Rh are different, this is not an indication that there will definitely be problems. Group and Rh are just the presence or absence of specific proteins in the blood. The reaction of the body and the development of pathologies in our time can be successfully controlled with the help of medications. Your attentiveness to your body, as well as an experienced doctor, will help you bear a healthy baby.

How do your chances of conceiving depend on your blood type?

Quite a lot is already known about the influence of blood groups, for example, on the likelihood of developing Alzheimer's disease, cancer, blood clots, etc. However, virtually nothing was known about the effect on fertility. And finally, thanks to the efforts of Turkish doctors, research has appeared in this area.

A study published last week found that men with type O are four times less likely to develop impotence compared to guys with other blood types. Experts from Ordu University in Turkey noted that blood type is as important a risk factor as smoking, excess weight, and high blood pressure. The reason is not clear, but scientists have said that in people with type A blood, the penis has a large number of veins, the lining of which can become damaged, leading to erectile dysfunction.

Blood type also affects female fertility. Girls with the second group are more likely to bear a healthy child for a long time than with the first. Studies have shown that women in the first group quickly deplete their egg reserves early in life. But at the same time, women with type 0 have a lower risk of developing preeclampsia - high blood pressure during pregnancy, which can be dangerous for mother and baby.

Naturally, representatives of the rest of humanity (which, by the way, are a little more than half, because people of the 1st group account for a little more than 40%) should not panic either - a higher probability does not mean a 100% chance. Likewise, representatives of the “happy” group should not relax ahead of time - reduced risk does not mean zero.

Lately there have been a lot of rumors about the so-called Rhesus conflict And group conflict. As soon as a woman finds out that she has a Rh-negative blood type, she almost goes into hysterics: “I’m in danger of having a Rh-negative conflict!” I won’t be able to carry the pregnancy!”
It gets to the point that some women say that they are contraindicated to become pregnant because they have an Rh-negative blood type. Many doctors give such absurd explanations that you are sometimes surprised at the lengths to which human imagination can go.

But what do the data of modern medicine and science say? I will try to explain to you that not everything is as scary regarding Rh and blood groups as you sometimes read about it or hear from acquaintances and friends.(iso-immunization, sensitization) is the condition of a woman when her defense system produces antibodies (IgG immunoglobulins) to foreign red blood cells (erythrocytes). Among the people, and even among doctors, the name “group or rhesus conflict” is common, which is outdated and inaccurate. Foreign red blood cells can enter the body of a pregnant woman through transfusion of blood and blood products and from the fetus under the influence of various factors. Thus, for the mother to produce antibodies, which can be determined using serological tests, fetal red blood cells must enter the mother's bloodstream.
Most often, fetal red blood cells enter the mother's bloodstream during termination of pregnancy (abortion, miscarriage), bleeding (placental abruption spontaneous or as a result of trauma), surgical procedures (chorionic villus sampling, amniocentesis, cordocentesis, manual separation of the placenta, laser coagulation of the vessels of the placenta or umbilical cord , etc.), ectopic pregnancy.
The woman’s defense system produces antibodies to specific agents (antigens) located on the surface of the fetal red blood cells. These antibodies belong to the IgG group, which means they can penetrate the placenta and enter the fetal bloodstream. With progressive pregnancy or subsequent pregnancies and the presence of a fetus carrying certain types of antigens, maternal antibodies destroy the red blood cells of the fetus, causing anemia (anemia) of the fetus, which may be mild or accompanied by fetal hydrops, which in turn can lead to its death due to for cardiovascular failure. This condition is called hemolytic disease of the fetus.

Newborn babies can also have hemolytic disease, which is often manifested by icteric discoloration of the baby's skin and an increased level of a special substance in the blood - bilirubin. Unfortunately, many doctors do not know that there are at least five types of newborn jaundice, and most often these jaundices are very safe, and hemolytic jaundice, requiring a blood transfusion, is uncommon - 1-2 cases per 10,000 newborns. Before the introduction into practice of preventing “Rhesus conflict” by administering anti-Rhesus antibodies to women in certain cases, 1% of all pregnancies occurred with manifestations of anti-Rhesus sensitization, that is, the appearance of anti-Rhesus antibodies in the mother’s blood. Now, thanks to timely prevention, Rh sensitization occurs in 10 cases per 10,000 births.
Maternal sensitization depends on the number of pregnancies. If before pregnancy a Rh-negative woman was not given blood and blood products (blood transfusion, blood plasma, administration of red blood cells), then there should be no anti-Rh antibodies in her serum. Therefore, even if fetal red blood cells enter the mother’s blood during the first pregnancy, the occurrence of hemolytic disease of the newborn is unlikely. During the normal course of the first pregnancy (without bleeding), fetal red blood cells can enter the mother’s body during childbirth, which is not dangerous for either the mother or the newborn. Such a child cannot have hemolytic disease of the newborn, although there may be other types of jaundice.
Theoretically, the first pregnancy in the absence of previous sensitization with blood products cannot occur with severe hemolytic disease of the fetus (or, as people say, with conflict). Even if during pregnancy a few red blood cells of the fetus enter the mother’s bloodstream, the mother’s body produces a minimal amount of antibodies, which, although they pass through the placenta and enter the fetus’ body, do not cause anemia. The more pregnancies, the greater the risk of sensitization, and therefore the risk of hemolytic anemia of the fetus increases.

It is important to understand that an Rh-negative woman and an Rh-positive father may not have a high chance of conceiving an Rh-positive child. Therefore, excessive reliance on numerous determinations of antibody titers or other methods of examining Rh-negative women is highly unjustified.
Another gross mistake, based on ignorance of the issue, is determining the titer of antibodies (anti-Rh, group) in the father of the child! It must be remembered that antibodies in the mother’s body are produced against the red blood cells of the fetus, since she is the carrier of this fetus. Men do not become pregnant, so they do not have direct contact with the fetus, and therefore there cannot be antibodies to the baby's red blood cells in their blood. Ignorance of this issue among medical personnel in some medical institutions of the former countries of the Union has reached a real absurdity, and a married couple is intimidated by numerous tests, which creates a lot of stress in the life of a pregnant woman.
The old concept of "hemolysins" is no longer used in modern medicine. Hemolysins are commonly understood as substances that destroy red blood cells, i.e. lead to hemolysis. There can be many such substances. Although maternal antibodies can destroy fetal red blood cells (have a hemolyzing effect on them), such antibodies are not hemolysins for the mother.
There are about 50 different erythrocyte antigens that can cause maternal allo-immunization and fetal hemolytic disease. However, the most common are the Rh group (Rh factor) antigens - D, c, C, E and e. Most often, fetal hemolytic anemia is caused by antigen D. With the introduction of prophylactic vaccines with anti-Rhesus immunoglobulin (RhoGAM, Anti-D, etc.) in the 60s into the daily practice of obstetricians, the level of maternal allo-immunization and cases of hemolytic disease decreased significantly in all countries peace.
A very small number of people have a so-called weak D-factor, or not expressed, sub-phenotypic. Older Rh reagents are poorly sensitive to this type of Rh factor, so these people were often considered Rh negative. With improvements in the sensitivity of reagents used to determine blood typing, some people are tested as Rh positive. To avoid confusion, people with a weak RhD antigen are considered Rh positive as donors, but must receive Rh negative blood type as recipients.

Rh-negative blood type occurs more often among the white population (Europeans - 15-16%, Spanish Basques - up to 35%), less often among the black population of North America (up to 7%), and even less often among the Asian and African populations (up to 1% ).
The process of sensitization is influenced by the group affiliation of the fetus. It turns out that if a Rh-positive child has the same blood type according to the ABO system as the mother, the mother has a 15-16% chance of allo-immunization, unless anti-Rh immunoglobulin has been administered before. If the child’s blood group according to the ABO system does not coincide with the mother’s blood group, then the chance of allo-imminusation is significantly reduced and amounts to 1.5-2%. This phenomenon is explained by the fact that the maternal defense system destroys fetal red blood cells that have entered the mother’s bloodstream by producing group antibodies even before anti-Rh antibodies begin to be produced in response to them.
The most common is allo-immunization with the RhD antigen with the development of specific antibodies to it. But with the widespread use of preventive vaccination in developed countries, cases of fetal hemolytic anemia in women with D antigen are occurring less and less frequently.
There are several types of other antigens to which antibodies can cause fetal anemia (hemolytic disease of the fetus). The antigens Kell, c, E are very well known. Almost rarely, hemolytic disease is associated with the following antigens: e, C, cE, Ce, Cw, Kpa, Kpb, k, Jka, s, Wra, Fya. Biles, Coa, Dia, Dib, Doa, Ena, Fyb, Good, Heibel, Jkb, Lua, Lub, M, Mia, Mta, N, Radin, S, U, Yta, Zd are extremely rare. Antibodies to the antigens Lea, Leb, P do not cause fetal anemia. Typically, laboratories determine antibodies to the 3-5 most common antigens.
The destruction of red blood cells is called hemolysis. Hemolysis can be caused by a number of factors. In the case of pregnancy, the antibodies that are produced by the mother are not dangerous for the woman herself, since they are produced against foreign red blood cells (erythrocytes) of the fetus. Penetrating through the placenta and umbilical cord into the bloodstream of the fetus, these antibodies can destroy the red blood cells of the fetus, causing hemolysis, and therefore anemia (anemia) of the fetus. This condition is called hemolytic disease of the fetus and newborn. When red blood cells break down, bilirubin is formed, which the liver does not have time to neutralize, and the kidneys do not have time to remove, which can manifest as jaundice. The degree of anemia of the fetus and newborn can range from mild to serious complications in the form of pleural effusion, ascites, which is called hydrops fetalis. In some cases, this condition can result in fetal death. In newborns, the danger is kernicterus - a condition when free bilirubin accumulates in the cells of the nervous system, primarily in the child’s brain, which can also lead to the death of the child or severe neurological consequences.
At the first visit to the doctor, every pregnant woman should have her blood type, Rh status and antibody titer determined. If a woman is Rh negative and does not have anti-Rhesus antibodies, she is a candidate for the introduction of anti-Rhesus immunoglobulins. If a woman is Rh negative and has antibodies, then the level of antibodies is monitored throughout pregnancy. If a woman is Rh positive, the level of anti-Rh antibodies is not determined.
It is not necessary for the child’s father to determine the blood type, much less determine the level of any antibodies, which many doctors do erroneously due to a lack of knowledge in this matter. Fetal red blood cells never enter the father's bloodstream, so the father cannot have antibodies to fetal red blood cells. It is advisable to determine the father's blood type only according to indications if the woman has a Rh-negative blood type, but it is even better to determine the genetic combination of Rh genes in order to predict the child's blood type. If a man has a Rh-negative blood group, then the probability of allo-immunization in a woman is negative. However, a woman’s husband or partner may not always be the child’s biological father (for example, after IVF with donor sperm). In 3-5% of pregnancies, paternity is unknown or uncertain. Thus, determining a man’s blood type does not always contain practical information. Another important aspect: if a man is Rh positive, this does not mean that the unborn child will necessarily have an Rh positive blood type.

The main goal of managing pregnant women with a negative Rh factor is to prevent sensitization, that is, the production of antibodies by the mother’s protective system to the child’s red blood cells that have entered the mother’s bloodstream. It is not always possible to prevent the entry of fetal red blood cells, although in such women the number of certain procedures (chorionic villus sampling, amniocentesis, cordocentesis) should be kept to a minimum. The production of antibodies is suppressed by the introduction of anti-Rhesus immunoglobulin, that is, a certain dose of ready-made antibodies. The mechanism of action of the administered antibodies has not been fully studied, although there is an assumption that these antibodies react with fetal red blood cells, which enter the mother’s bloodstream most often during childbirth or during invasive procedures, and the mother’s own defense system does not have time to react to foreign red blood cells. that is, the mother’s primary immune response is suppressed. In 1963, anti-Rhesus immunoglobulin was introduced into the practice of doctors, which made it possible to significantly reduce the level of sensitization in women.
In a relationship "group-conflict" I can reassure you that maternal sensitization to fetal red blood cells due to the group factor is rare and occurs without significant complications for the fetus, and is very rarely accompanied by miscarriages.
Thus, your blood type, as well as the blood type of the father of the unborn child, should not be a contraindication to pregnancy. Get pregnant and give birth to health!

H What should be done to prevent Rhesus conflict?
1. If a woman has Rh-negative blood, regardless of the Rh factor of the baby's father, it is necessary to donate blood to determine anti-Rh antibodies between the first visit to the doctor and 18-20 weeks. Early determination of the antibody titer is carried out only in those women who have in the past had cases of Rh conflict or the birth of children with hemolytic disease of the newborn.
2. If the titer is up to 1:4, a repeat blood test for antibodies should be performed at the 28th week of pregnancy, or earlier if abnormalities in fetal development are detected. In some hospitals, antibody levels are monitored every 6-8 weeks.
3. If at 28 weeks of pregnancy the titer is 1:4 or less, the first dose of anti-Rhesus antibodies (vaccine) must be administered. This vaccine is safe for pregnant women.
4. If the titer up to 20 weeks is more than 1:4, then an additional determination of the titer of anti-Rhesus antibodies is carried out once every 1-2 weeks, or more often, depending on the dynamics of its growth and the condition of the fetus.
5. If antibodies are detected in a woman, it is necessary to monitor the condition of the fetus using ultrasound (once every 1-2 weeks), including Doppler ultrasound (after 24 weeks). If the fetal condition worsens, an intrauterine fetal blood transfusion is necessary. If intrauterine blood transfusion is not possible, discuss delivery. Expectant management can lead to fetal death.
6. After birth, it is important to prevent future Rh conflicts, so the blood type of the newborn is determined within 72 hours. If the child's blood type is Rh negative, the woman does not need a second dose of the vaccine. If the child's blood type is Rh-positive, it is necessary to administer anti-Rhesus antibodies to the mother if she does not have them. If antibodies are detected in the mother during pregnancy, then it is useless to administer anti-Rhesus immunoglobulins. The administration of anti-Rhesus antibodies in the presence of antibodies in the blood of a pregnant woman is carried out as a treatment according to a special regimen only in very rare cases for the treatment of anti-Rhesus sensitization after numerous pregnancy losses.
7. Anti-Rhesus vaccination must be carried out in women with Rh-negative blood after artificial termination of pregnancy, a number of procedures (sampling of amniotic fluid, chorionic villus sampling, etc.), ectopic pregnancy, or diagnosed spontaneous abortion. After the introduction of antibodies, their level in the woman's bloodstream quickly decreases to minimal titers over several days or weeks.
The achievements of modern medicine inspire more and more hope and leave less and less chance for problems associated with Rh factor incompatibility.

When a couple decides to have a child, the man and woman often have questions about whether their Rh blood is compatible. For quite some time now, doctors and scientists have been studying these indicators. This article will tell you about the Rh factor compatibility. You will find out in what cases you should not worry about the formation of antibodies in blood cells. It is also worth saying what the Rh factor conflict is during pregnancy.

What is Rh in human blood?

Blood rhesus is the presence or absence of a certain protein on the membrane of red blood cells. In most cases it is present. This is why approximately 80 percent of the population has positive Rh values. About 15-20 percent of people become owners of negative blood. This is not some kind of pathology. In recent years, scientists have been talking about the fact that these people become special.

Rh factor: compatibility

Quite a long time ago, data became known that some blood goes well together, but other types do not. To calculate compatibility by Rh factor for conception or for other purposes, you need to refer to the tables. They are presented to your attention in this article. Depending on what you want to know, compatibility information may vary. Let's consider in what cases the compatibility of Rh factors is recognized and when it is not.

Donation

The Rh factor will be compatible in the case of blood donation in the following cases. A person with a positive value (when the so-called protein is present on the red blood cells) can pass the material for negative people. This blood is transfused to all recipients, regardless of whether they have Rh.

The Rh factor does not provide compatibility when a negative donor donates material for a positive person. In this case, serious cell conflict may occur. It is worth recalling that during transfusion of material it is necessary to take into account the compatibility of the Rh factor. This is exactly what experienced specialists do within the walls of medical institutions.

Planning a pregnancy

The compatibility of the Rh factors of the parents of the unborn baby is of great importance. Many couples mistakenly believe that the likelihood of conception depends on these values. Thus, with long-term infertility of unknown origin, a man and a woman blame their blood type and Rh affiliation. This is completely false.

It does not matter at all whether there is protein on the red blood cells of sexual partners. This fact does not in any way affect the likelihood of fertilization. However, during fertilization and establishing the fact of pregnancy, the Rh factor (compatibility of its indicators between the father and mother) plays a big role. How do these values ​​affect the unborn child?

Compatible Rh factors

  • If a man does not have protein on his red blood cells, then most often there is no danger. In this case, a woman can be positive or negative. This fact is absolutely not important.
  • When a woman's Rh factor is positive, the man's blood data is not particularly important. The father of the future baby can have any analysis indicators.

Possibility of conflict

The compatibility of the Rh factors of the parents may be impaired when the woman is negative and the man is positive. In this case, whose indicators the future baby acquired plays a big role. Currently, there are certain tests of the mother's blood. Their result can determine the identity of the child’s blood with up to 90 percent accuracy. Also, during pregnancy, women are recommended to take a blood test to determine the presence of antibodies. This helps prevent conflict and prevent it in time.

during pregnancy

While carrying a child, many women face various problems. One of them is incompatibility in blood group and Rh factor. In fact, it doesn’t matter at all what blood (type) the expectant mother has. The presence or absence of protein on the red blood cells of a pregnant woman is much more important.

If the woman’s Rh factor is negative, and the man (the father of the unborn baby) is positive, then a conflict may develop. But this will only happen if the fetus has acquired the properties of its father’s blood.

How does the complication develop?

The blood of the baby is determined even at about 12 weeks, the fetus develops independently due to the action of progesterone. In the second half of pregnancy, a continuous connection and mutual exchange of substances occurs between the mother and the unborn baby. The blood of a woman and the fetus are in no way connected with each other. However, the baby receives all its nutrients and oxygen through the umbilical cord. It gives away components it does not need, with which red blood cells can be released. Thus, the protein found on the blood cells enters the body of the expectant mother. Her circulatory system does not know this element and perceives it as a foreign body.

As a result of this entire process, the pregnant woman’s body produces antibodies. They are aimed at destroying the unknown protein and neutralizing its effect. Since most substances from the mother pass to the fetus through the umbilical cord, antibodies enter the baby’s body using the same method.

What is the risk of Rh conflict?

If a woman has those same antibodies in her blood, they can soon reach the fetus. Next, the substances begin to destroy the unknown protein and destroy the baby’s normal red blood cells. The consequence of such exposure can be many congenital diseases or intrauterine complications.

Often babies who have undergone a Rh conflict with their mother suffer from jaundice. It is worth saying that such a complication becomes one of the most harmless. When red blood cells break down, bilirubin is formed in the baby's blood. It is this that causes the yellowness of the skin and mucous membranes.

After the birth of a child with Rh conflict, diseases of the liver, heart and spleen are often detected. The pathology can be easily corrected or quite serious. It all depends on the duration of the destructive effect of antibodies on the child’s body.

In rare cases, Rh conflict during pregnancy can lead to stillbirths or

What are the signs of complications?

Is it possible to somehow find out about the developing Rh conflict during pregnancy? In most cases, pathology is detected by a blood test. Every expectant mother who has negative Rh values ​​should regularly donate material from a vein for diagnosis. If the result shows the presence of antibodies in the body, then doctors take measures aimed at improving the baby’s condition.

Also, a routine ultrasound examination allows you to suspect Rh conflict during pregnancy. If, during diagnosis, a specialist discovers increased sizes of organs such as the liver and spleen, then perhaps the complication is already developing in full force. Diagnostics may also show swelling of the child’s entire body. This outcome occurs in more severe cases.

Correction of Rh conflict during pregnancy

After detecting a pathology, you need to sensibly assess the condition of the unborn child. In many ways, the treatment regimen depends on the stage of pregnancy.

So, in the early stages (up to 32-34 weeks) it is used in women. A new material is introduced into her body that does not have formed antibodies. Her blood, which is destructive for the child, is simply removed from the body. This regimen is usually carried out once a week until possible delivery.

In late pregnancy, a decision may be made to have an emergency caesarean section. After birth, the child’s condition is corrected. Most often, the treatment regimen includes the use of medications, physiotherapy, exposure to blue lamps, and so on. In more severe cases, a blood transfusion to the newborn is used.

Prevention of Rh conflict during pregnancy

Is it possible to somehow prevent the development of pathology? Absolutely yes. Currently, there is a medicine that fights the formed antibodies.

If this is your first pregnancy, then the likelihood of developing a Rh conflict is minimal. Most often, red blood cells do not mix. However, during childbirth, the inevitable formation of antibodies occurs. That is why it is necessary to administer the antidote within three days after the birth of a child with positive Rh in a negative mother. This effect will avoid complications in subsequent pregnancies.

What to do if time is lost and another conception occurs? Is there any way to protect your child from conflict? In this case, the expectant mother is recommended to regularly monitor her blood condition through routine tests. The above substance is introduced into the body of a pregnant woman at approximately 28 weeks. This allows you to carry your baby to term without complications.

Summarizing

You now know what the compatibility table for blood groups and Rh factor looks like. If you do not have the same protein on your red blood cells, then you should definitely tell your doctor about it. During pregnancy, special monitoring will be carried out over your well-being and the behavior of the fetus. This will allow you to avoid the occurrence of Rh conflict or prevent it in a timely manner. Good health to you!

Update: October 2018

Most women who are preparing to become mothers have heard about the “terrible and terrible” Rh conflict during pregnancy. But this problem concerns only those representatives of the fairer sex whose blood is Rh negative.

Rh conflict during pregnancy threatens only those pregnant women and those planning a pregnancy who have negative Rh blood, and even then, not in 100% of cases.

Let's understand the Rh factor

It is known that human blood consists of red blood cells or erythrocytes, which are responsible for the transport of oxygen, white blood cells - leukocytes, which guard the health of the body, platelets, which are responsible for blood clotting and many other cells and systems.

The Rh factor is a D protein, which is an antigen and is localized on the surface of red blood cells. A significant proportion of people have the Rh factor, then their blood is called Rh positive. For example:

  • Among Europeans, there are 85% of Rh-positive people
  • while for Africans this figure rises to 93%
  • among Asians up to 99%

If D protein is not detected, then such people are called Rh negative. The Rh factor is determined genetically, just like hair or eye color, it remains for life and does not change. The presence or absence of the Rh factor does not bring any benefit or harm; it is simply a characteristic feature of each person.

What is this – Rhesus conflict?

Click to enlarge

It becomes clear that pregnancy with Rh conflict occurs in situations where the mother’s blood is Rh negative, and the father’s, on the contrary, is Rh positive, and the unborn child inherits the Rh factor from him.

However, this situation occurs in no more than 60% of cases, and the occurrence of Rh conflict accounts for only 1.5%. The mechanism of Rh conflict while waiting for the birth of a baby is that the red blood cells of the fetus, which carry the D-antigen, meet the red blood cells of a Rh-negative pregnant woman and stick together, that is, agglutination occurs.

To prevent clumping, the mother’s immunity is activated, the immune system begins to intensively synthesize antibodies that bind to the antigen - the Rh factor and prevent clumping. These antibodies or immunoglobulins can be of two types, both IgM and IgG.

  • Rh conflict during the first pregnancy

It almost never occurs, which is due to the production of type 1 immunoglobulins. IgM is very large and cannot cross the placenta to enter the fetal bloodstream. And in order for the red blood cells of the unborn child and antibodies to meet, they need to “collide” in the gap between the uterine wall and the placenta. The first pregnancy almost completely eliminates this situation, which prevents the development of a Rh conflict situation.

  • If a woman becomes pregnant again with an Rh-positive fetus

In this case, his red blood cells, penetrating the mother’s vascular system, “trigger” an immune response, during which IgG begins to be produced. These antibodies are small in size, they easily cross the placental barrier, penetrate the baby’s bloodstream, where they begin to destroy his red blood cells, that is, cause hemolysis.

In the process of destruction of the red blood cells of the fetus, bilirubin is formed from them, which in significant quantities is a toxic substance for the child. Excessive formation of bilirubin and its action contributes to the development of such a formidable pathology as hemolytic disease of the fetus and newborn.

What leads to Rh conflict?

For the development of Rh conflict, two conditions are needed:

  • Firstly, the fetus must have Rh-positive blood, which means it will inherit its Rh-positive father
  • Secondly, the mother’s blood must be sensitized, that is, have antibodies to the D-protein.

The production of antibodies is mainly due to previous pregnancies, no matter how they ended. The main thing is that there was a meeting between maternal blood and fetal blood, after which IgM antibodies were developed. It could be:

  • previous births (during the process of expulsion of the fetus, contact with its blood cannot be avoided by a woman)
  • C-section
  • ectopic pregnancy
  • artificial termination of pregnancy (regardless of the method, both surgical and)
  • spontaneous miscarriage
  • separation of the placenta by hand.

It is also possible to develop antibodies after performing invasive procedures during gestation, for example, after cordocentesis or amniocentesis. And such a reason cannot be ruled out, although this is rather nonsense, like transfusion of Rh-positive blood to a woman in the past who has an Rh-negative factor.

Diseases of the woman who is carrying the baby are also important. , diabetes mellitus, ARVI and influenza damage the villi, and, consequently, the chorion vessels and the blood of the mother and the unborn baby mix.

But you should know that hematopoiesis in the fetus begins to form from the 8th week of embryogenesis, which means that abortions performed before 7 weeks are safe in terms of the development of an Rh conflict situation in the future.

Manifestations of Rh conflict

There are no external, that is, visible manifestations of Rh conflict. Incompatibility of maternal and fetal blood does not in any way affect the condition of the pregnant woman. As described above, the Rh conflict “ripens” during the second pregnancy, and with each subsequent pregnancy the risk of this condition increases.

Incompatibility of the blood of the child and the expectant mother according to the Rh factor has a very adverse effect on his condition and health in the future. To find out what devastating damage the Rhesus conflict has caused to the baby, an ultrasound scan of the fetus is performed. During an ultrasound examination, the following signs are clearly visualized:

  • the contour of the head becomes double, which indicates edema
  • the placenta and umbilical vein swell and increase in diameter
  • Fluid accumulates in the abdominal cavity, heart sac, and chest
  • the size of the fetal abdomen exceeds the norm
  • splenohepatomegaly develops (increase in the size of the liver and spleen), the fetal heart is larger than normal
  • the baby in the uterus takes a certain position in which the legs are spread apart due to the large belly - this is called the “Buddha pose”

All of these ultrasound signs indicate the development of hemolytic disease of the fetus, and after birth it will be called hemolytic disease of the newborn. This pathology has three forms:

  • icteric
  • edematous
  • and anemic

The most unfavorable and severe is the edematous form. The icteric form ranks second in severity. A child who has high levels of bilirubin in the bloodstream after birth is very lethargic, apathetic, has poor appetite, constantly regurgitates (see), has reduced reflexes, and often has convulsions and vomiting.

Bilirubin intoxication negatively affects the child in utero, and is fraught with the development of mental and mental disability. In the anemic form, the fetus has a lack of red blood cells, which causes oxygen starvation (hypoxia) and immature red blood cells (erythroblasts, reticulocytes) are present in large quantities in the blood.

Diagnostics and dynamic control

In the diagnosis of the described pathology, the woman’s early attendance at the antenatal clinic is of great importance, especially if this is the second, third, etc. pregnancy and the pregnant woman has been diagnosed with either antibody sensitization in the past, or, which is much more unfavorable, a history of hemolytic disease of the fetus/newborn.

  • When registering at a dispensary, all pregnant women, without exception, are determined by their blood type and Rh status.
  • If the mother is diagnosed with Rh-negative blood, in this case, determination of the group and Rh factor in the father is indicated.
  • If he has a positive Rh factor, a woman up to 20 weeks of pregnancy is prescribed tests for antibody titer every 28 days.
  • It is important to determine the type of immunoglobulins (IgM or IgG).
  • After the pregnancy has reached the second half (after 20 weeks), the woman is sent for observation to a specialized center.
  • After 32 weeks, a blood test for antibody titer is carried out every 14 days, and after 35 every 7 days.
  • The prognosis depends on the gestational age (see) in which the antibodies were detected. The earlier the Rh factor immunoglobulins were diagnosed, the more unfavorable it is.

If antibodies are detected, especially if there is a second pregnancy and the chances of an Rh conflict increase, the condition of the fetus is assessed, which is carried out using both non-invasive and invasive methods.

Non-invasive ways to determine the condition of the unborn baby:

Ultrasound should be performed at 18, 24–26, 30–32, 34–36 weeks of gestation and on the eve of birth. The position of the child, swelling of the tissues, dilated umbilical veins, and how the baby grows and develops are determined.

  • Doppler

The speed of blood flow in the placental vessels and in the unborn child is assessed.

  • Cardiotocography (CTG)

Allows you to determine the state of the heart and vascular system in the fetus and diagnose the presence of a lack of oxygen (hypoxia).

Invasive methods:

  • Amniocentesis

During amniocentesis, amniotic fluid is collected by puncturing the amniotic fluid and the bilirubin content in it is determined. Amniocentesis is prescribed when the antibody titer is 1:16 or higher and is performed at 34–36 weeks. The negative aspects of this procedure should also be taken into account. Amniocentesis is fraught with infection, leakage of amniotic fluid, premature rupture of water, bleeding and placental abruption.

  • Cordocentesis

The essence of the procedure is to puncture the umbilical vein and take blood from it. A highly informative method for diagnosing hemolytic disease, in addition, it allows intrauterine blood transfusion to the fetus. Cordocentesis has the same negative aspects as amniocentesis, and the formation of a hematoma at the puncture site or bleeding from it is also possible. This manipulation is carried out when the antibody titer is 1: 32 and in the case of hemolytic disease of the fetus/newborn in the previous child or his death.

Methods for countering Rhesus conflict

Today, there is only one way to alleviate the condition of the fetus and improve its situation - this is intrauterine blood transfusion through cordocentesis. This method reduces the likelihood of premature birth and the development of severe hemolytic disease after birth. All other methods do not have a significant effect or are completely useless (desensitizing treatment, transplantation of a skin flap from the mother’s husband, etc.).

A woman usually gives birth ahead of schedule. Preference is given to abdominal delivery, since in this case the risk of complications is reduced. But in some situations (absence of hypoxia, gestational age more than 36 weeks, not the first birth) independent childbirth is also possible.

To prevent Rh conflict during the next pregnancy, a first-time mother is given anti-Rhesus immunoglobulin within 72 hours after the birth of the child, which will destroy the baby's red blood cells that enter the mother's blood, which will prevent the formation of antibodies to them.

It is for the same purpose that specific immunoglobulin is administered after artificial and spontaneous termination of pregnancy. In addition, the administration of immunoglobulin after an ectopic pregnancy and for bleeding during the current period of gestation is indicated. For prevention purposes, administration of this immunoglobulin is indicated at 28 and 34 weeks.

Rhesus conflict and breastfeeding

There is no consensus on the issue of breastfeeding during Rh conflict. Doctors evaluate the baby’s condition and possible risks, and in some cases, immediately after birth, they do not recommend breastfeeding for several days, sufficient to remove antibodies from the mother’s body.

However, there is also the opposite opinion of doctors that such a restriction is not necessary. There are no proper studies in this area confirming this or that position yet.

What does rhesus conflict portend?

The consequences of pregnancy with Rh-conflict are very unfavorable. The presence of a huge amount of bilirubin in a child’s blood affects the condition of his internal organs and brain (the damaging effect of bilirubin).

Hemolytic disease of the newborn often develops, the baby has mental retardation, and his death is possible, both in the womb and after birth. In addition, Rh conflict is the cause of termination of pregnancy and recurrent miscarriage.

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