Rhesus conflict and the mechanism of its development
Rh-conflict pregnancy - is the incompatibility of the child having a positive blood Rh factor, and a mother with Rh-negative blood group.
Rh antigen is a protein that is found in the erythrocyte membrane of most people.Therefore, their blood system is considered to be Rh positive.At the same, in whose blood this protein is not present, Rh negative.This feature has approximately 1/3 of the world population.
interesting to follow the laws.
1. My mother with a positive Rh factor in the blood and "negative" child conflict does not occur.This combination does not threaten either the fetus or woman.
2. If the father and mother Rh negative, then it is transferred to the child, and this, too, is not at risk.
3. But if the mother's blood is Rh-negative and the father Rh-positive in 60% of cases the fetus inherits a positive Rh factor, and only 1.5% of the number of children developing Rhesus conflict.
As a result of the incompatibility of the Rh
factors causing Rh conflict:
abortions, abortion (medical and instrumental);
complications during gestation (premature detachment of the placenta);
invasive studies, such as puncture of the umbilical cord or membranes;
immunization through blood transfusion;
intravenous drug using the same needle.
Rh-conflict pregnancy: symptoms
have clinical manifestations of the mother rhesus no.Her health does not suffer.A symptoms are detected in the fetus by ultrasound:
accumulation of fluid in the chest and abdomen, as well as the pericardium;
baby belly increases;
child is in a "posture of Buddha", his feet set aside from the increased stomach;
enlarged heart, liver and spleen.
ultrasound observed double contour of the head - it is the result of swelling of soft tissues;
thickening of the placenta and umbilical cord vein increase.
Depending on what symptoms of Rh-conflict pregnancy more pronounced, there are the following forms of hemolytic disease of the fetus: icteric, swelling and anemic.
Diagnosis and management of pregnancy with Rh-conflict
task of the physician, the leading women with the described problem - early diagnosis of Rh-conflict mother and fetus and to determine the optimal timing of delivery in case.In the mother and father of the child is determined blood group. If the mother is Rh negative and the father is positive, about once a month a woman doing the analysis on antibodies, tracking dynamics.Up to 20 weeks of observation of Rh-conflict pregnancy is carried out in the antenatal clinic.After - in a specialized center, where he addressed the issue of timing and method of delivery.
modern obstetrics known only treatment of hemolytic disease of the fetus with proven efficacy - is intrauterine blood transfusion. It is conducted in severe anemia in children.Implementation of the procedure is only possible in the hospital.Blood transfusion helps to achieve a noticeable improvement in the state of the baby and reduces the risk of premature birth, as well as development of serious diseases after birth.
blood purification techniques woman (hemosorbtion, plasmapheresis), as well as the procedures that affect the immune system (immunoglobulin therapy, desensitization therapy) were found to be ineffective.
But the most effective way to end the conflict Rh during pregnancy - this is the cessation of receipt of maternal antibodies to the fetus, that is, delivery.
Features rhesus at the first and second pregnancy
When Rh-positive red blood cells encounter on your way Rh-negative, then there is their bonding - agglutination. To avoid this, the immune system of the mother with Rh-negative proteins generates antibodies that bind to antigens of the fetus.The antibodies called immunoglobulins and are of two types - IgM and IgG.
fetal antigens and antibodies are contacted in the space between the placenta and uterine wall.The first meeting of Rh-positive red blood cells from the immune system of an Rh-negative mother leads to the development of IgM.However, their size is too large to cross the placenta.Therefore at the first pregnancy, Rh-conflict mother and fetus appears less frequently.
apparent incompatibility develops during the re-merger of fetal antigens and blood Rh-negative mother, that is, when the second pregnancy. Then a woman's immune system begins to produce IgG in large quantities.Since they are smaller, then penetrate the placenta and cause destruction of red blood cells of the child.Thus developing Rhesus conflict during the second pregnancy.
Today to prevent Rh-conflict mother and fetus are used Rh immunoglobulin D. effectiveness of this drug proved.There are several of its trade names "Rh immunoglobulin D» (Russia), "resonator" (France), "Giperrou" (USA).
Preventive measures should be taken in the 28th week of the term in the absence of antibodies in the mother's blood, because in this period the risk of exposure of women of antibodies to antigens of the fetus increases dramatically, and thus increases the likelihood of Rh-conflict pregnancy.
If the patient is planning a second child, then for 72 hours after administration of the drug prevention pore repeated.Also, repeated injections do whatever the outcome of pregnancy, whether miscarriage , ectopic pregnancy or abortion.In case of heavy bleeding a doctor increases the dose.