Rhesus conflict during pregnancy - incompatibility of the blood of the expectant mother and the blood of the fetus according to the Rh factor. The conflict of Rh factors can only occur in a woman with Rh-negative blood, if the fetus is Rh-positive. The probability of such a combination occurs in 8-9% of pregnant women, and only 0.8% of this number has an Rhesus conflict..

Conflict of Rh factorsThe Rh factor is an immunological property of the blood, depending on the presence of a special type of protein, which does not affect the body and is inherited. The presence of antigen in erythrocytes (85% of the population) - positive Rh factor, negative Rh factor (15%) - the absence of antigen in erythrocytes. The Rh factor does not change throughout life..

The conflict of Rh factors manifests itself only in the case of direct blood contact, which is possible during pregnancy, if the mother has Rh-negative blood, and the fetus has inherited a positive Rh from the father. Rh conflict does not develop when an Rh-negative child is born to an Rh-positive mother..

Antibodies formed in the blood of a woman as a result of the Rhesus conflict are present in her throughout her life.. They are produced every time a woman's Rh-negative blood comes into contact with any Rh-positive blood, enhancing the immune response.. That is why the Rh conflict during pregnancy may not manifest itself if it is the first. Sometimes problems occur in the last months of the first pregnancy, but usually they are minor.. With each subsequent pregnancy, the mother's immune response increases as more and more antibodies are produced against the Rh-positive fetus. Penetrating through the placenta into the blood of the fetus, antibodies cause a hemolytic disorder - Rh conflict. Its consequences may be:.

Spontaneous abortion at different times;

preterm birth;

Stillbirth;

Jaundice in newborns requiring a blood transfusion.

Timely detection of Rh conflict, thanks to modern methods of prevention and treatment, can significantly reduce the risk of such consequences..

Rh-conflict, symptoms Rh-conflict with her fetus is not reflected on the body of a Rh-negative pregnant woman. If the expectant mother has a negative Rh factor, the father of the child is Rh-positive, and antibodies to the Rh factor are found in the woman's blood, a fetal examination is necessary.

With an Rhesus conflict, the symptoms of hemolytic disease of the fetus are detected on ultrasound and may be as follows:.

Swelling and accumulation of fluid in cavities - chest, abdominal, pericardial sac;

Enlargement of internal organs - heart, liver, spleen;

Visual bifurcation of the contour of the fetal head - the result of soft tissue edema;

Thickening of the placenta and an increase in the diameter of the umbilical vein due to placental edema;

The fetus instead of the “fetal position” takes the “Buddha posture” - the limbs are laid aside from the tummy enlarged by the accumulated fluid.

If a blood test determines the presence of anemia, reticulocytosis, erythroblastosis, jaundice in the fetus, these are also symptoms of an Rhesus conflict.

In the most difficult cases of Rh conflict, dropsy of the fetus and edematous syndrome of the newborn develop, which can lead to stillbirth or death of an already born child..

Rhesus conflict during pregnancy In the presence of a negative Rh factor in the expectant mother and a positive one in the father, in order to establish a Rh conflict, during pregnancy it is necessary to do a blood test of the pregnant woman for antibodies to the Rh factor. The analysis is done up to 28 weeks from conception, when antibodies can begin to be synthesized in the current pregnancy.

Activation of the immune system by Rh-positive blood in a woman occurs in the following cases:.

Previous pregnancies and births if the fetus was Rh positive;

Miscarriages, medical abortions, ectopic pregnancies, and bleeding in Rh-positive pregnancies;

Getting Rh-positive blood through transfusions;

Passage of invasive prenatal tests - amniocentesis, chorionic biopsy.

Antibodies formed in all cases accumulate in the body of a woman. During pregnancy, they penetrate the placenta into the blood of an Rh-positive fetus and, due to the Rh conflict, destroy red blood cells - erythrocytes..

The doctor can determine the beginning of the Rh conflict during pregnancy and assume the Rh factor of the unborn child only with regular monitoring of a blood test from a woman's vein for antibodies. Such an analysis in Rh-negative pregnant women up to 32 weeks is carried out once a month, up to 35 weeks - 2 times a month, and until childbirth - weekly.

How to reduce the negative consequences of the Rh conflict for the unborn child is decided by a qualified specialist, taking into account the results of blood tests of the future mother and the condition of the fetus. The use of the following therapeutic and preventive measures, individually or in combination, makes it possible to give birth to a healthy child with a Rh conflict:.

Vaccination of the mother with anti-Rh immunoglobulin in all cases of contact of her Rh-negative blood with Rh-positive blood (after abortions, previous births, miscarriages). The drug binds the formed antibodies and removes them from the body;

Prophylactic vaccination with anti-Rh immunoglobulin of a pregnant woman in the current pregnancy, starting from the 28th week, or within 72 hours after bleeding, amniocetosis;

Cordocentesis - intrauterine blood transfusion through the umbilical cord to the fetus;

Activation of preterm labor, according to the state of the fetus;

Exchange transfusion for newborn;

Phototherapy of a newborn under special blue lamps.

The key to the birth of a healthy baby with Rh-positive blood in an Rh-negative mother is a timely visit to the antenatal clinic, it is better even at the stage of pregnancy planning. A qualified doctor will determine the necessary measures to prevent the development of Rhesus conflict.

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