Many people know about the importance of the Rh factor during blood transfusion. But not everyone correctly assesses its significance for the baby, if it is negative for a woman and positive for a man. But in these circumstances, the baby may face serious illness and even death before birth. Signs of Rh conflict during pregnancy in the early stages will let you know about the danger. They are easily identified by specialists if a woman registers on time. Then the chances of a healthy baby being born increase.
Read in this article
Briefly about Rhesus conflict
Part of the blood consists of red blood cells and plasma. When mixed, the former make it possible to replenish its volume in the body in case of need through transfusion. And during pregnancy, the woman’s blood serves as a source of nutrition for the embryo. Red blood cells contain substances that sometimes make a person’s biological fluid unacceptable to another due to lack of compatibility. These are agglutinins and the Rh factor. But not everyone has the latter. Blood containing these particles is Rh positive. Their absence makes it negative.
When the mother is a carrier of just such blood, and the father has Rh particles, the fetus can inherit the properties of his biological fluid. That is, incompatibility arises between the woman and the embryo. Her blood counters this discrepancy by producing anti-Rh agglutinins. Substances enter the placenta, blind red blood cells, making the existence of the fetus problematic. By these actions, the mother’s body protects itself from foreign particles of the embryo’s blood, pushing it to death.
Detection of signs of Rh conflict during pregnancy in the early stages makes it possible to neutralize it so that the danger to the existence and health of the future little person is minimized.
Signs of Rh incompatibility in an expectant mother
Both parents should know their own blood type and Rh status at the stage of pregnancy planning. Mothers with a negative indicator should treat this with special care. But even for women who have Rh particles in their blood, there is a possibility that after conception a similar conflict will arise.
If it is the first pregnancy, the woman’s blood produces a minimal amount of anti-Rhesus agglutinins. In this case, the risk to the fetus is low. Therefore, for women with Rh-negative blood, maintaining the first pregnancy is fundamentally important. This is the best way to give birth to a healthy child, since with each subsequent attempt, in case of blood incompatibility, the body produces more and more protective particles dangerous to the fetus.
The difficulty is also hidden in the fact that the Rhesus conflict during early pregnancy, the mother’s symptoms clinically almost do not indicate its presence. That is, she often does not feel anything special that would indicate this serious problem. A frequent but optional accompaniment of Rh conflict is. Then a woman can observe in herself:
- Increased heaviness and pain in the abdomen. They are also felt in the lower back;
- General weakness;
- Difficulty breathing due to a raised diaphragm;
- High blood pressure;
- in the absence of physical activity;
- Swelling of the legs;
- Characteristic gurgling sounds inside the abdomen;
- Stretch marks appearing on the skin;
- Abdominal size inappropriate for pregnancy.
But suspicious people can feel the same way, and self-confident people do not attach importance to these symptoms. In addition, polyhydramnios is caused by other reasons, not just the incompatibility of the blood elements of the mother and baby. Therefore, at an early stage of pregnancy, more reliable ones are needed.
How is the diagnosis carried out?
Rh conflict is determined by testing the mother's blood. It is required first when registering a pregnant woman. First, in fact, the blood type and Rh are established, that is, the possibility of the problem itself is studied. If the risk is determined, from the 8-10th week anti-Rhesus agglutinins can already be detected in the biological fluid.
A pregnant woman donates blood more than once to be tested for antibodies. A special protein is placed in the biological fluid, which is broken down in the presence of anti-Rhesus agglutinins in it. This reaction is clearly visible to a specialist; moreover, it is even possible to determine the amount of such substances. The blood is diluted with protein until it stops reacting. In this way, the volume of anti-Rhesus particles and the level of danger to the embryo are determined.
If a blood test of the expectant mother gives a positive result, it is repeated as the pregnancy progresses, and studied in other ways to monitor the situation and maintain it.
First signs in the fetus
Rhesus conflict can be reliably recognized by fetal indicators, which are determined using hardware tests. And the faster they are carried out, the more likely a successful outcome for the baby.
Symptoms of Rh conflict during pregnancy at an early stage are as follows:
- Incorrect position of the embryo in the uterus. The usual position for an unborn child is with the arms folded on the chest and the legs pulled up to the stomach. The embryo appears curled up into a ball. With Rh-conflict, his abdomen is enlarged due to swelling, and his limbs are spread apart. Doctors call the position the Buddha pose;
- Double outlines of the head on ultrasound. This is also caused by fluid retention in soft tissues;
- Increased size of the placenta and umbilical vein. They arise due to impaired blood flow caused by Rh conflict. The placenta has more blood vessels than normal and they become thicker;
- Enlargement of the liver and spleen. This is also due to impaired hematopoiesis and hypoxia.
Over time, the features of the signs of Rh conflict during pregnancy in the early stages become more distinct:
- Anemia. Antibodies produced by a woman’s blood reach the placenta, where they interact with the red blood cells of the embryo. The latter are destroyed, which makes it difficult to supply the tissues of the unborn baby with oxygen;
- Reticulocytosis. Instead of mature red blood cells, particles that lack a nucleus are formed in excessive quantities. This occurs due to an acute lack of oxygen;
- Erythroblastosis. The formation of another early form of red blood cells, also anucleate and unable to support the normal formation of the fetus;
- Increased bilirubin. Occurs due to a malfunction of the liver of the unborn baby.
Methods for identifying signs of blood incompatibility based on embryonic parameters
What symptoms of Rh conflict occur during early pregnancy are identified using:
- Ultrasound. The screen shows areas of swelling of the internal organs of the fetus, which in these circumstances are enlarged;
- Doppler. This method will detect increased blood viscosity. It occurs in the embryo due to the destruction of red blood cells, which makes the blood flow slow;
- Cardiotocography. The study is aimed at identifying deficiencies in the formation of the cardiovascular system, which, in case of Rh conflict, makes these organs enlarged due to edema.
Identified signs of Rh conflict during early pregnancy are a chance of having a healthy baby. Modern medicine is able to neutralize the factors that interfere with its prenatal development and in a later period. But for this purpose, detection and treatment methods are used, which themselves can cause placental abruption, the introduction of infections into the embryo’s body, leakage of amniotic fluid, premature birth and many other complications.
In the article we discuss the Rh factor during pregnancy - what it is, in what situations a Rh conflict occurs and its consequences for the child. You will learn how the Rh factor affects a woman, whether it can change during pregnancy, and what parents should do if an Rh conflict arises.
What is the Rh factor and Rh conflict
Rh factor during pregnancy does not always lead to Rh conflict
Rh factor or Rh is a special protein that is found on the surface of red blood cells. When this protein is absent in the blood, it is called a negative Rh factor; when present, it is called a positive Rh factor.
Some women are interested in the question of whether the Rh factor can change during pregnancy. The answer is negative - Rhesus remains for life. However, there is such a phenomenon as a weakly positive Rh factor. In such people, the amount of protein is so small that the reaction is either positive or negative. If you are diagnosed with weak positive Rh, evaluate it as follows:
- Rh+ during pregnancy;
- Rh- during blood transfusion;
- Rh+ upon donation.
Since the embryo develops a negative and positive Rh factor during pregnancy already in the first trimester, it is important to determine it in time. If the Rhesus of the mother and child do not match, an Rhesus conflict may occur.
Rh conflict is the immune response of the mother’s body to the red blood cells of the fetus. Some of the baby's red blood cells penetrate the placenta into the woman's blood. Her immune system does not recognize the “new proteins” and begins to defend itself and produce appropriate antibodies to the Rh factor during pregnancy. Antibodies aggressively attack the placenta, penetrate the fetal blood and destroy “foreign” red blood cells on which the Rh antigen is located.
The effect of the Rh factor on pregnancy is not always negative. Even if Rh antibodies appear in the blood of a pregnant woman, it is not necessary that they will harm the child. The mother's blood, amniotic fluid and placenta contain special biological filters that retain antibodies and do not allow them to pass to the fetus. The child's protection is enhanced if his mother is healthy and the pregnancy proceeds without complications. Everything changes if a woman suffers from toxicosis, there is a threat of abortion, partial abruption of the placenta, or invasive research is carried out during pregnancy. Then the effectiveness of protection drops sharply.
When does Rh conflict occur?
Rh conflict is not dangerous if you have Rh compatibility, that is, the mother’s body does not perceive the child as a foreign body. Compatibility occurs both with a positive and negative Rh factor of a woman:
- When a mother is Rh+, she already has Rh protein in her blood. Regardless of what Rh the father or child has, the immune system will calmly accept the appearance of the same protein, and a conflict will not begin.
- The same applies if the woman has a negative Rh factor during pregnancy, the father is negative and the child is negative. The baby inherits the Rh factor of the parents, and their blood is similar.
- The option does not cause problems when a woman has a negative Rh factor during pregnancy, the father is Rh+, and the child is born with Rh-. In this case, the blood of the mother and fetus are completely compatible.
A conflict of Rh factor during pregnancy occurs when a father with positive Rh transmits it to the child, and the mother has a negative Rh factor.
The risk of Rh conflict increases if a woman has a history of:
- birth of a child with Rh+;
- intrauterine fetal death;
- abortion, miscarriage;
- ectopic pregnancy;
- Rh+ blood transfusion.
When parents have different Rh factors during pregnancy, the consequences for the child can be unfavorable and sometimes catastrophic:
- oxygen starvation and anemia;
- dropsy with swelling of internal organs;
- hemolytic jaundice;
- disruption of brain function;
- hearing and speech disorders;
- reticulocytosis;
- erythroblastosis;
- fetal death.
Even if the child survives the attacks of antibodies and does not die, the expectant mother will face severe manifestations of toxicosis and general weakness of the body.
Compatibility table of Rh factors by blood group
When planning a baby, it is important for parents to know their blood types and Rh factor in order to prevent Rh conflict
If parents have different blood types during pregnancy, compatibility may also be impaired. Blood groups differ in the presence of proteins type A and B:
- in the first blood group (0) - there are no proteins;
- the second blood group (A) has protein A;
- the third blood group (B) has protein B;
- the fourth blood group (AB) has both proteins.
Depending on the father’s blood type and Rh factor, the pregnancy compatibility table will show the likelihood of an immunological conflict. In all cases, the mother's Rh factor is negative.
The most favorable situation is when the mother has a negative blood type 4, and pregnancy depends only on the father’s Rh, and not the blood type.
Prevention of Rhesus conflict
To prevent Rh conflict, doctors carry out preventive vaccination with immunoglobulin. Anti-Rhesus immunoglobulin during pregnancy with a negative Rh factor destroys the baby’s red blood cells that have entered the mother’s body, and her immune system has time to react.
Vaccination is done twice - before childbirth and immediately after childbirth:
- If the pregnancy proceeds without complications before 28-32 weeks, the mother is given a dose of anti-D immunoglobulin, which protects the embryo until birth.
- If after the first vaccination there is a threat of miscarriage with bloody discharge, an abdominal injury occurs after a car accident or fall, therapeutic and diagnostic interventions are performed, for example, cordocentesis or chorionic biopsy, the drug is re-administered.
- If the baby's Rh factor is confirmed positive after birth, the doctor gives an injection of anti-D immunoglobulin to protect the next pregnancy. Vaccination is carried out within 72 hours after birth, but not later.
What to do if your parents have a Rh factor conflict
Even when the mother has a negative Rh factor during her first pregnancy, and the child has a positive one, this does not mean that a conflict will necessarily arise. If a woman has no history of abortion, miscarriage or blood transfusion, the risk of developing Rh conflict does not exceed 10%. The likelihood of conflict remains low during the second pregnancy, if antibodies to the child’s Rh are not formed.
Another question is when antibodies appeared in large quantities during the first pregnancy. In this case, a negative Rh factor during the second pregnancy will sharply increase the likelihood of Rh conflict. As soon as the fetal red blood cells penetrate the mother’s blood, the “memory cells” quickly organize the production of antibodies and provoke the destruction of the child’s red blood cells. And with each new pregnancy this risk will only increase. For this reason, a negative Rh factor during the third pregnancy most often causes adverse consequences.
What should parents do with Rhesus conflict?
The first thing such parents need to do is register with a gynecologist. If the parents have different Rh factors during pregnancy, the woman should regularly donate blood from a vein to determine antibodies to fetal red blood cells and their quantity:
- from 7 to 32 weeks - once a month;
- from 33 to 35 weeks - 2 times a month;
- from 36 to 40 weeks - 1 time per week.
If antibodies do not appear by 28-32 weeks, you will be given injections of anti-Rhesus immunoglolin. If antibodies are detected in you, and their number increases, the doctor will diagnose the onset of Rh conflict and prescribe appropriate treatment.
Treatment of pregnant women with Rh-conflict is carried out in a specialized perinatal center under the constant supervision of doctors. To reduce the reaction of the mother's immune system to the fetal blood protein, desensitizing therapy is prescribed - the introduction of ascorbic acid, vitamins, glucose, calcium gluconate and cocarboxylase. If the titers of anti-Rhesus antibodies do not decrease, the woman is hospitalized in the pregnancy pathology department.
Planning a pregnancy with negative Rhesus
Incompatibility of Rh factors during pregnancy should be taken into account already at the planning stage. Recommendations for women with Rh negative blood:
- Determine in advance the father’s blood type and Rh factor.
- Eat right, avoid stress, and exercise to strengthen your immune system and prevent possible breakdowns.
- Save your first pregnancy and do not have abortions.
Also, at the stage of pregnancy planning, buy anti-Rhesus immunoglobulin, since it is not always available in antenatal clinics and maternity hospitals.
For more information about Rhesus conflict, watch the video:
What to remember
- A negative Rh factor is when there are no special proteins in the blood.
- Rh conflict - when the mother is Rh negative and the child is Rh positive, and the woman’s immune system destroys the fetal cells.
- The risk of Rh conflict during the first pregnancy is no more than 10%. With each subsequent child the risk increases.
- If a woman has a negative Rh factor during pregnancy, the consequences for the child are anemia, jaundice, dropsy, and death.
- The best treatment for Rh conflict is immunoglobulin prophylaxis.
- In order to promptly notice the appearance and increase in the amount of antibodies in the mother’s body, regularly donate blood from a vein to check the antibody titer.
Most women have heard about the frightening Rh conflict between mother and child. But lack of knowledge and understanding leads to excessive fear and panic among pregnant women. Let's figure out what it is and in what cases you need to worry.
Rh+ (positive) and Rh- (negative)- this is how the Rh factor is designated. Before planning a pregnancy, mother and father must find out their Rh factor. Since an immune conflict can begin due to inheritance from the father of a positive Rhesus fetus.
Rh conflict during pregnancy
When the characteristics of the mother’s blood data do not coincide with the data of the unborn baby (this happens if the mother is negative and the father is positive), then a Rh conflict begins to develop.
The phenomenon is defined as follows − red blood cells from an Rh-positive baby enter the blood of an Rh-negative mother and the immune system immediately identifies them as foreign bodies. The mother's body begins to actively produce antibodies that kill the fetal blood cells, considering them foreign and inappropriate.
The consequences of such a reaction of the body are tragic for the unborn child. The mother's immune system destroys the fetus's red blood cells, which leads to an enlargement of the spleen and liver due to increased production of blood cells. Most often, the forming organism is not able to cope with this phenomenon and the fetus begins to suffer, as a result of which death can occur. Fortunately, Rhesus conflict occurs extremely rarely in pregnant women.
The main causes of Rh conflict between mother and fetus
For a mother with Rh negative, the baby's positive blood is a threat, so the body begins to fight the danger. There is an exchange of blood between the mother and baby between the uterus and the placenta, so antibodies can enter the blood of the fetus.
Often, Rh conflict occurs during the second pregnancy (even after an abortion or miscarriage). Everything is explained by the fact that during a previous pregnancy, blood mixing occurred, and, consequently, the production of antibodies began. Special antibodies remain in the mother's blood throughout her life. Therefore, during a second pregnancy, they can have a detrimental effect on the development of the fetus.
What affects the production of antibodies:
- when blood is mixed, production is observed (during childbirth);
- before pregnancy, the woman had or happened;
- after undergoing a biopsy or amniocentesis;
- bleeding in the mother during childbirth;
- during pregnancy, injuries that led to damage to the baby’s blood vessels or the placenta and mixed blood;
- the development of antibodies in the blood is accompanied by abortion;
- after a blood transfusion.
Antibody production does not affect the mother’s body in any way after childbirth. They can be identified through a special test. Their presence in maternal blood does not always cause a conflict, but only in the case of mixing positive and negative Rhesus.
Rhesus conflict during the first pregnancy does not have a detrimental effect on the fetus, since the production of antibodies is just beginning in the mother’s blood. The placenta has thick walls, so antibodies cannot penetrate through it. The action of antibodies is still little aimed at actively combating foreign bodies.
Over time, antibody immunity strengthens and the risk of Rh conflict in subsequent pregnancies increases significantly. The placental barrier is no longer a problem for antibodies; they easily overcome it and begin to destroy the fetal red blood cells. The consequence of the destruction of red cells is fraught with the development of fetal anemia and a sharp decrease in hemoglobin levels.
Consequences for the child from Rh conflict during pregnancy
The destruction of red blood cells leads to toxic damage by the breakdown product of hemoglobin to almost all the internal organs of the baby. The central nervous system is primarily affected, followed by intoxication of the liver and kidneys, and the heart is affected. In severe cases, this leads to intrauterine fetal death. Rh-negative mothers are at risk of not carrying a child to term.
Risk of conflict during the gestation period it is 0.8%.
Table of probability of conflict by Rh factor
Symptoms of Rh factor conflict during pregnancy
Rhesus conflict is a very complex phenomenon, so it is extremely difficult to track the symptoms. The conflict is determined only by .
Signs of this violation:
- a pregnant woman experiences swelling in all parts of the body, which is explained by the accumulation of fluid;
- the study showed a significant increase in fetal size;
- the abnormal size of the fetal abdomen is visible, which is why the legs are moved to the side;
- the liver and spleen suffer, which leads to their enlargement;
- swelling of the placenta is observed.
Antibody test during pregnancy
Rh-negative women are required to take blood test to detect antibodies in the blood. This happens with the following frequency:
- First trimester - blood is taken for analysis once.
- 2nd trimester - blood samples are taken for analysis twice.
If the tests confirm increased antibody titre, then the risk of conflict is high. Therefore, in critical situations, doctors terminate pregnancy. Mostly, problematic pregnancies take place under the watchful supervision of a leading doctor and the necessary therapy, which leads to positive results in bearing a child.
Determination of the degree of fetal damage based on the results of the study
The condition of the fetus is determined by a complex of studies:
- Ultrasound- the first ultrasound examination is performed at 18 weeks. Thanks to it, the condition of the placenta and tissues is determined.
- . The work of the heart is examined and the speed of blood flow in the blood vessels is determined.
- — the cardiovascular system is examined to exclude the presence of hypoxia.
- Invasive tests. Determination of the amount of bilirubin.
Treatment of Rhesus conflict and delivery
Basic treatment consists of blood transfusion to the fetus. The risk of the operation is very high, but the result is justified - the condition of the fetus is normalized and premature birth is excluded. Plasmapheresis was previously used, but such treatment methods were found to be ineffective. The only way out is to see a doctor and follow the recommendations.
Pregnancy with the presence of Rh conflict most likely ends in planned premature birth. Based on the test results, doctors decide to terminate the pregnancy or continue it. It is extremely rare for natural birth to occur with Rhesus conflict, Cesarean section is mainly used.
Preventative measures for Rh factor
To prevent conflict, the pregnant woman is given immunoglobulin. This substance is used within three days of childbirth, abortion or miscarriage. Such a procedure cannot be ruled out during pregnancy.
After giving birth, some doctors ask you to abstain from so that the body can remove all antibodies. Then, according to the child's condition The doctor allows you to breastfeed.
Some doctors are of the opinion that it is not worth limiting feeding in case of Rh conflict. Therefore, it is better to look at the baby’s condition and listen to the doctor’s recommendations.
Video about Rhesus conflict
When planning a pregnancy, expectant mothers are advised to watch a video where doctor Violetta Frolova talks in detail about the effect of the Rh factor on pregnancy.
Preserving the life and health of the fetus is one of the tasks of the gynecologist who manages the pregnancy. Together with the expectant mother for nine months, he tries to do everything so that the baby is born without pathologies and on time. But there are situations when a pregnant woman’s body, for one reason or another, perceives the fetus not as a natural state, but as a foreign body and begins to actively fight it.
One such example is the Rh conflict that arises between a mother and a pregnant child. It happens in cases when a woman who decides to become a mother has a negative Rh factor, but the fetus is positive.
To avoid critical situations, it is advisable for both parents to donate blood during planning - after all, Rh conflict during pregnancy can have serious consequences for the child, including his intrauterine death.
- It is important to understand that in case of Rh conflict, the key factor is the Rh factor of the blood, not the group!
What is positive and negative Rh?
In 85% of people, red blood cells contain a protein on their surface called Rh antigen. We know it as the Rh factor.
There are only 50 antigens, but most often, when referring to the Rh factor, doctors mean the presence of antigen D, as the most immunogenic. The blood of people who have such a protein on the surface of their red blood cells is defined as Rh positive. In approximately 15–17% of the population, no antigens are found in the blood on the surface of red blood cells.
Such people are defined as Rh negative. When procreating, they can pass on their Rh factor to their children, or not at all, if the partner has a positive Rh antigen. In medicine, these types of blood are assigned the corresponding designations: Rh+ and Rh-.
The presence of Rh- blood is not a pathology; rather, it is simply a genetic feature. The life of such people is no different from others.
The only problem may arise during pregnancy, and in cases where both future parents have a negative Rh factor, the likelihood of Rh conflict is excluded altogether.
When does Rh conflict occur during pregnancy?
In order for a Rh conflict to occur, the mother must have Rh- blood, and the fetus must have Rh+ blood. This combination can only appear if the future father has positive blood, and then the probability that the child will inherit the father’s Rh antigen is not 100%.
The baby may well take negative blood from the mother and then an immunological conflict will be excluded. The possibility for this is quite large: 50% that the fetus will have Rh- blood, and 50% that the fetus will have Rh+ blood.
We must not forget - if there was no Rh conflict in the first pregnancy, then in the second the fetus may with the same probability inherit the positive blood of the father, and for the successful bearing of the child constant medical supervision and the administration of special medications will be necessary.
Currently, doctors have developed special testing regimens and medications that are prescribed for pregnant women in the event of an immunological conflict with the fetus.
But if the situation is neglected and the doctor’s instructions are ignored, the pregnancy can end in disaster. The condition of the baby will also be serious if he is born.
In total, several outcomes can be identified in the absence of competent therapy in such situations:
Stillbirth – can happen either prematurely or on time. The baby dies in utero due to failure of internal organs, numerous internal and external edema, and accumulated fluid inside the body.
In other words, the child’s body cannot cope with the biological attack of the mother’s body, which treats the fetus as a foreign body.
High bilirubin levels in a newborn – as a result of the fact that the fetus had to constantly defend itself from attacks by the mother’s immune system, its liver worked for most of the pregnancy. The woman's antibodies penetrated the placenta and damaged the red blood cells in the baby's blood. As a result, after birth, red blood cells are unable to carry oxygen.
Because of this, hemoglobin comes out of them and is converted into bilirubin. The loss of large amounts of hemoglobin causes the liver to produce large numbers of red blood cells. It is because of this that it increases in size, but bilirubin levels do not fall.
If doctors fail to bring the situation under control, the child's brain can be seriously damaged.
Fetal hypoxia – develops as antibodies increase in the mother’s blood during pregnancy. Its appearance is directly related to the destruction of the child’s red blood cells, which cannot sufficiently supply oxygen. As a result of hypoxia, the entire body suffers, especially the brain.
The gynecologist must conduct additional examinations of the pregnant woman to determine the presence and degree of oxygen starvation of the fetus.
Thickening of the placenta – is formed due to an attack by the antibodies of the mother’s immune system, which are able to penetrate the child’s place. The placenta reacts to any external threats directed at the child, be it viruses, oxygen starvation or the influence of antibodies, by premature aging (that is, thickening).
As a result, it changes its structure, which no longer allows the exchange of useful substances between mother and fetus to proceed normally.
The consequences for the child of Rh conflict during pregnancy can be very serious - if treatment and preventive measures are not taken. Therefore, when planning a pregnancy, you need to mentally prepare yourself for the fact that you will have to visit antenatal clinics much more often than other expectant mothers.
Probability of Rh conflict during pregnancy + table
Mother Rh+, father Rh+
There cannot be a Rhesus conflict. In 75% of cases with this combination, the child inherits Rh+ blood. But in 25% of cases, Rh-positive parents may have a baby with Rh- blood.
Mother Rh+, father Rh-
There cannot be a Rhesus conflict. However, it is difficult to predict what kind of blood a child will inherit, since in 50% of cases it can be Rh+, and with the same degree of probability the baby can be born with Rh- blood.
Mother Rh-, father Rh+
There is a possibility of Rh conflict. The risks increase with the second and subsequent pregnancies, so doctors advise such women not to have abortions, especially if this is their first pregnancy. The probability of inheritance is the same as in the previous case: 50% that the baby will have Rh+ blood, and 50% that the baby will have Rh- blood.
Mother Rh-, father Rh-
There cannot be a Rhesus conflict. Unlike parents who have a positive Rh factor, in this case the possibility of having a child with Rh+ blood is completely excluded. Such a couple can only have children with a negative Rh factor.
It is obvious that different Rh factors of parents during pregnancy do not always cause an immunological conflict with the fetus. And if the child’s blood matches the mother’s Rh antigen, then the pregnancy has every chance of proceeding without complications. Moreover, blood type does not matter here.
For convenience, we provide a table of Rh conflict during pregnancy.
| MOTHER | DAD | CHILD | PROBABILITY OF CONFLICT |
| + | + | 75% + 25% - | No |
| - | + | 50% + 50% - | yes - 50% |
| + | - | 50% + 50% - | No |
| - | - | 100% - | No |
Preventive measures for the development of Rh conflict
The likelihood of an immunological conflict between mother and fetus increases with each subsequent pregnancy. For the same reason, the process of bearing a child worsens. In each case, the doctor individually decides which preventive regimen to choose for the patient.
If this is the first pregnancy, then the test for Rh antibodies is carried out in the second trimester, from 18 to 20 weeks. If the number of antibodies is 1:4 inclusive, then the next examination is carried out only after 10 weeks. If antibody levels are elevated, titers are monitored once every one and a half to two weeks.
A blood test is taken at exactly the same frequency, starting from week 30, even if the antibody levels are within the normal range. In the ninth month of pregnancy, examinations are carried out once every 7 days.
Since when doctors talk about the Rh factor, they mean the D antigen, during pregnancy, at the beginning of the seventh month, the expectant mother is given anti-Rh immunoglobulin D if she is Rh negative.
Carrying a child with Rhesus conflict requires increased attention from both doctors and the woman herself. However, medicine today provides ample opportunities for such a pregnancy to end successfully - with the birth of a healthy baby.
What does the concept of Rh conflict mean? It is a special protein located on the surface of red blood cells. All people except 15% of the planet's inhabitants have it. Therefore, most of them are called Rh positive, the rest are called Rh negative.
The Rh factor is an immunological quality of blood that has absolutely no effect on health. Only Rh-positive blood is considered stronger.
Conflict of blood between mother and child during pregnancy
Having come into contact with each other, positive and negative red blood cells stick together. This process has virtually no effect on Rh-positive blood. Pregnant women with negative Rhesus will also have a normal pregnancy. Especially if the father has the same Rh.Rh conflict during pregnancy occurs when the father is found to be Rh positive, then most likely the child will also have Rp+. In this case, Rh conflict is possible.
It is possible to establish Rp in a baby in a safe way only approximately, based on the parents’ coefficients.
Rhesus conflict occurs infrequently - only in 0.8% of cases. However, this can have serious consequences. Why? A positive Rp baby for a mother with negative blood is a serious danger. In order to cope with it, the female body begins to produce antibodies that react with the child’s red blood cells and destroy them. This action is called hemolysis. In the space between the placenta and the uterus, the blood of mother and child meets. And then an exchange occurs: oxygen and vital components enter the blood of the fetus, and the products of its vital activity enter the mother’s body. At the same time, some of the red blood cells change places, as a result of which positive fetal cells enter the mother’s blood, her red blood cells, and therefore antibodies, enter the child’s blood.
During the second pregnancy, the occurrence of an Rh conflict is much more likely, because the woman’s body, having second contact with Rh-negative blood cells, begins to produce other antibodies - IgG. They freely enter the child's body through the placenta. As a result, hemolysis continues there, and the breakdown product of hemoglobin, the toxin bilirubin, accumulates in the body.
Table of Rh conflict by blood group during pregnancy and inheritance by child
| Father | Mother | Child | Probability of conflict |
|---|---|---|---|
| 0 (1) | 0 (1) | 0 (1) | No |
| 0 (1) | A (2) | 0 (1) or A (2) | No |
| 0 (1) | AT 3) | 0 (1) or B (3) | No |
| 0 (1) | AB (4) | A (2) or B (3) | No |
| A (2) | 0 (1) | 0 (1) or A (2) | 50% chance of conflict |
| A (2) | A (2) | 0 (1) or A (2) | No |
| A (2) | AT 3) | 25% chance of conflict | |
| A (2) | AB (4) | 0 (1) or A (2) or AB (4) | No |
| AT 3) | 0 (1) | 0 (1) or B (3) | 50% chance of conflict |
| AT 3) | A (2) | any 0 (1) or A (2) or B (3) or AB (4) | 50% chance of conflict |
| AT 3) | AT 3) | 0 (1) or B (3) | No |
| AT 3) | AB (4) | 0 (1) or B (3) or AB (4) | No |
| AB (4) | 0 (1) | A (2) or B (3) | 100% chance of conflict |
| AB (4) | A (2) | 0 (1) or A (2) or AB (4) | 66% chance of conflict |
| AB (4) | AT 3) | 0 (1) or B (3) or AB (4) | 66% chance of conflict |
| AB (4) | AB (4) | A (2) or B (3) or AB (4) | No |
Why is Rh conflict dangerous?
Fluid accumulates in the child’s organs and cavities, which disrupts the development of almost all body systems. Even after the baby is born, antibodies from the mother’s blood still act in his body for some time, which means hemolysis continues, resulting in the so-called hemolytic disease of the newborn. Sometimes a miscarriage occurs due to Rh conflict. This phenomenon is often the cause of miscarriage.Symptoms
There are no clear signs. At least from my mother. They can be seen in the fetus. On an ultrasound, you can see abnormalities in the fetus - accumulated fluid in the cavities, swelling; unnatural fetal position; the stomach is enlarged, the legs are spread apart; double head contour; changed placenta size and umbilical vein diameter.There are three forms of the disease: icteric, edematous, anemic.
Edema is the most severe and dangerous for the baby. After giving birth, they often end up in intensive care. In case of icteric form, the amount of bilirubin in the amniotic fluid is determined. The anemic form is the mildest.
How to determine the presence of Rh conflict
Antibody testing is one of the methods for determining the presence of Rh conflict. To determine the risk group, it is given to all pregnant women and fathers too. The earlier it is detected, the more complications such a pregnancy promises, because the Rh conflict accumulates. Fetal damage: how to determine its degree?
First of all, from the 18th week of pregnancy it is an ultrasound. Doctors pay attention to the child’s posture, the condition of the tissues, placenta, etc.Using the Doppler procedure, cardiac activity is assessed and the speed at which blood flow moves in the blood vessels of the placenta and baby is determined.
CTG is used to determine the degree of reactivity of the cardiovascular system and the presence of hypoxia.
There are two invasive ways to assess fetal position. Amniocynthosis - when the amniotic sac is punctured and amniotic fluid is taken for analysis. This makes it possible to determine the level of bilirubin, and at the same time to very accurately assess the condition of the fetus.
Cordocentosis - when the umbilical cord is pierced and blood is taken for analysis. This method is even more accurate. It is used to give a blood transfusion to the fetus.
Like amniocentesis, this method is quite unsafe. It also leads to complications and poses a risk of developing a hematoma on the umbilical cord.
