Surely, all future mothers have heard about thisphenomenon, such as rhesus conflict during pregnancy. However, few people have an exact idea of what it is and what it is eaten with. As a brief introduction, it is worth recalling where the concept of rhesus conflict came from. If you strain yourself and remember the school biology curriculum, you can recall that rhesus is the name of a breed of monkeys. It was in them that scientists first discovered a certain factor in the blood, which was named after these monkeys. And if expectant mothers got an "A" in biology at school, they will probably remember that the rhesus factor is a certain type of protein that is located on the surface of red blood cells - a certain group of blood cells. However, these proteins are not present in all people. If they are present, the person has a positive rhesus factor, if they are absent, the rhesus factor is negative. By the way, the rhesus positive group is most often found in representatives of the Caucasian ("white") race - about 87% of all people. And only 13% - negative Rh factor. Starting from about the tenth week of intrauterine development of the fetus, it begins to produce antigens of the Rh system. It is at this moment that it becomes clear whether the child will have Rh positive or Rh negative blood factor.
At what point does Rh conflict develop?
If the expectant mother has Rh factor –factor differs from the Rh factor of the blood, during pregnancy there is a very high risk that during pregnancy a Rh conflict will develop. Moreover, doctors have established the following pattern: if the child's blood has a Rh factor - positive, the risk of developing a Rh conflict is much higher than if the mother is a carrier of the Rh factor - positive. And the consequences of such a Rh conflict can be much more serious. That is why in almost all cases, when talking about Rh conflict, doctors mean the combination of "Rhesus - positive blood type in the child and Rh - negative blood type in the mother." As a rule, such a combination "mother + baby" occurs if the mother of the child has a negative Rh factor in the blood, but the father has a positive one. Rh conflict in this case is observed in about 80% of all pregnancies.
What is the danger of Rhesus conflict?
Let's try to figure out why this is sois this rhesus conflict dangerous and why is there such a fuss around it? In fact, the explanation is quite simple - if the body of a person with a rhesus-negative blood factor gets rhesus-positive blood erythrocytes into his blood, the body will perceive them as foreign agents. The human immune system will not hesitate to begin immediate production of antibodies that are designed to destroy these foreign agents. And as you can guess, if such antibodies get into the body of a pregnant woman, her body will begin to fight the future baby. And this is very, very dangerous for both the mother's body and the fetus. This happens in the following way. Almost instantly, antibodies produced by the mother's body penetrate the placenta into the circulatory system of the child's body. Having penetrated it, the antibodies immediately begin to destroy the child's erythrocytes, and, as a result, entail a number of very serious consequences. Red blood cells stop performing their function in full – full oxygen transport to the child’s tissue cells is disrupted. This pathological condition of the child, which develops as a result of the penetration of Rh antibodies into his blood, is called hemolytic disease in medicine, which has several forms of progression:
- Anemic form.This form of the disease is the mildest. The first sign that appears in the first week after the baby is born is a pronounced pallor of the cyanotic integuments. In addition, the baby's liver and spleen are slightly enlarged. The baby's general health does not suffer much.
- Jaundice form.This form of hemolytic disease is the most common. It is manifested by a significant increase in the size of the liver and spleen, the appearance of primary jaundice. As bilirubin breaks down, the child's condition worsens, and quite severe anemia develops.
- Edematous form.If the Rh factor conflict is very strong, the course of the disease is most severe. Thus, in the early stages, such a pregnancy is spontaneously interrupted. But even if the pregnancy is saved, the child is born in a very serious condition. The body tissues are very edematous, fluids accumulate in the abdominal and chest cavities. Such babies are extremely lethargic, their reflexes and general tone are very depressed. In addition, most children have serious cardiopulmonary insufficiency.
Factors provoking the production of antibodies
However, not in all cases is Rhesus –conflict pregnancy, the development of the above-described rhesus conflict between mother and baby occurs. Sometimes, during such pregnancies, the amount of antibodies produced by the female body is so small that it is not capable of causing any significant harm to the child's body. And sometimes they are not produced at all. So why are these antibodies produced in huge quantities in some cases and pose a danger to the body of the future child, while in others they are either produced in small quantities or are absent altogether? This is what will be discussed below:
- Penetration of children's blood into the circulatory system of the maternal organism
If the baby's blood is somehowpenetrated into the mother's bloodstream, a rapid production of antibodies begins. This can happen in a number of cases, for example, during a spontaneous termination of pregnancy in its early stages, or a surgical abortion, during childbirth, during amniocentesis - a puncture of the abdominal wall and uterus, in order to collect amniotic fluid. In addition, the likelihood of the baby's blood entering the mother's circulatory system is significantly increased by the presence of certain infectious diseases in the expectant mother, which significantly increase the permeability of the placenta, as well as its minor injuries, such as hemorrhages.
- Previously produced antibodies
In some cases, a woman who hasnegative Rh factor of blood, antibodies were developed long before pregnancy, sometimes many years before it. This can happen in a number of cases, for example, if a woman was once given a blood transfusion without taking into account the Rh factor. Many people are puzzled as to how antibodies developed years ago can affect the course of a Rh-conflict pregnancy. In fact, everything is very, very simple - it is enough for foreign red blood cells to enter a woman's body just once, and the active production of not only antibodies, but also specific memory cells begins, which, unlike antibodies, remain in the woman's body for the rest of her life. And subsequently, it is enough for just one red blood cell to enter the body's bloodstream, in order for the process of active antibody production to begin. By the way, this is why Rh-conflict situations are so rare in the case of a first pregnancy - 70% less often than in the case of a repeat pregnancy. This must be taken into account and certain preventive measures must be taken. Otherwise, during subsequent pregnancies in case of Rhesus conflict, serious problems cannot be avoided, because during childbirth, the contact of the child's blood with a positive Rhesus factor will inevitably enter the body of the mother with a negative Rhesus factor blood. The same applies to those cases when the first pregnancy ends in a miscarriage or artificial termination of pregnancy.
What to do in this situation?
But it often happens that a woman has everythingthere is a very high probability of developing a Rhesus conflict during pregnancy. What should be done in this situation? Is it really impossible to avoid a tragedy? However, doctors give a very favorable prognosis for the course of such a pregnancy. Of course, if you approach this issue with all seriousness and responsibility. And the first thing that needs to be done is to very carefully approach the issue of pregnancy planning. Knowing about the peculiarities of her body, the expectant mother should carefully avoid all situations in which Rhesus-incompatible blood may enter her body. As a rule, this can happen in the following cases: abortion, miscarriage, blood transfusion. In all these cases, it is necessary to introduce a special drug into the woman's body as soon as possible, which will prevent the female body from producing antibodies to the Rhesus factor. After a woman finds out about her pregnancy, she should try to register with a gynecologist as soon as possible. Moreover, she should inform the doctor about this peculiarity of her body on her very first visit. The doctor will treat your pregnancy with special attention. In particular, you will have to regularly take blood tests to determine the presence of antibodies in it - in the first trimester of pregnancy - once every two weeks, in the second trimester - once a week, and in the third - twice a week. If everything goes smoothly and without complications - antibodies in the blood of the expectant mother will not be detected, at about 28 weeks of pregnancy the doctor may decide on the need to administer a special anti-Rhesus immunoglobulin. This so-called "vaccine" binds the baby's red blood cells that have entered the mother's bloodstream. Thanks to this, the possibility that the mother's body will begin to produce antibodies in response to this penetration and a Rhesus conflict will develop is almost completely excluded. In the same case, if the blood test shows an increased antibody titer, urgent hospitalization will be required in special maternity hospitals or perinatal centers that specialize in the management of such Rhesus - conflict pregnancies, or at least to the maternity hospital where there are doctors familiar with this problem. This hospitalization is simply vital for both the mother and the baby. In the perinatal center, doctors will be able to provide the woman with all the necessary assistance. In addition, both the mother and the baby will be under the constant careful supervision of doctors. They will monitor:
- Changes - a decrease or increase in the level of antibodies in the blood of a pregnant woman.
- Dimensions of the liver of the future baby, the thickness of his placenta, the presence of polyhydramnios.
- The condition of amniotic fluid and cord blood, if necessary.
In the event that, through the efforts of doctors, a womanIf you manage to carry your baby to term, the delivery will be performed by a planned caesarean section. In the same case, if the situation becomes critical, and the pregnancy period does not yet allow the child to survive outside the mother's body, doctors will resort to a blood transfusion. This allows you to prolong the pregnancy. As a rule, doctors try to avoid natural childbirth, since in case of a Rh-conflict pregnancy it is very important to exclude the possibility of maternal antibodies entering the child's body as quickly as possible. In the same case, if everything went in the most favorable way, and no antibodies were produced during pregnancy, despite the fact that the mother is Rh-negative and the child is Rh-positive, on the very first day after birth it is necessary to administer a special injection of anti-Rh-immunoglobulin, which will bind Rh-positive erythrocytes, thus preventing the production of antibodies by the woman's body. This measure will help reduce the risk of developing possible problems during subsequent pregnancies. Therefore, do not leave this issue to chance, but be sure to monitor it, despite the fact that doctors of any maternity hospital should do this without a reminder, it would not be superfluous to remind them about it. And do it before the start of labor, because after it you will be completely absorbed in your baby, which can easily forget about it yourself. Moreover, the most reasonable thing would be to buy this drug yourself and take it with you to the maternity hospital. In the event that your first Rh-incompatible pregnancy ended successfully, during it antibodies were not produced, and the injection was made on time, the second pregnancy will be practically no different from the first - the risk of developing a Rhesus conflict will be no more than 10%. And remember the most important thing - the possibility of developing a Rhesus conflict in itself should in no way become a reason for refusing the opportunity to become pregnant, as well as the presence of antibodies in the body. Of course, pregnancy, during which there is a risk of developing a Rhesus conflict, requires a much more serious and responsible approach, but its successful outcome is very likely. Just make sure to find a competent and competent doctor in this matter. And, of course, carefully follow all his recommendations. We recommend reading:
