Not so long ago negative Rh factor blood during pregnancy was a serious threat to its course. Doctors predicted that the expectant mother, especially if she was pregnant with her second or third child, would experience a whole range of negative consequences for the baby. If a woman, having a negative Rh factor, for some reason decided to artificially terminate pregnancy, an abortion could cause further childlessness.

Today the situation has changed dramatically. Modern diagnostic and therapeutic methods make it possible to minimize the risks of negative indicators of this parameter in the mother.

What is the Rh factor?

The blood of humans and animals contains red blood cells, on the surface of which there is an antigen or protein called the Rh factor. This is a constant indicator and cannot change during life. Sometimes there is evidence that after medical manipulations in a person this blood parameter changes. But it has been scientifically proven that changing it is impossible. The answer to the question why such information appears is erroneous results determining the presence of antigen before or after medical manipulation.

If a person’s red blood cells have this antigen, the Rh factor is called positive; if it does not, it is called negative. More than 85% of the world's population are Rh positive carriers. Information about whether a person has an antigen or not is necessary when giving a blood transfusion or providing emergency care. medical care, surgical intervention. These parameters are sometimes used to determine the sex of the unborn child, but there is no data confirming the accuracy of such methods.

It is reliably known that the discovery of a negative Rh factor du in a patient means that, if necessary, he is given a blood transfusion only with a negative indicator.

During pregnancy, the Rh factor is very important. If the mother is negative and the husband is positive, the baby may inherit the father's antigen. This is fraught with the development of Rh conflict, which the mother’s body will fight with the active production of antibodies, perceiving the growing baby as a foreign body. If measures are not taken, the course of such a pregnancy will end negatively.

The compatibility of Rh factors and blood groups with each other is determined using a special table.

(Table picture)

When both spouses have the same positive or negative Rh factor, they have nothing to worry about. It is necessary to take measures during pregnancy only when different meanings this indicator among young parents.

Features of pregnancy with negative Rhesus

If the parents have different antigen levels, and there is a possibility of Rh conflict during pregnancy, this is not a reason for frustration. Close supervision by specialists and regular testing, as well as knowledge of how to give birth with a negative Rhesus, will help you get through this stage without risks for the child.

During the first pregnancy

Only during pregnancy does a woman encounter unfamiliar, foreign antigens for the first time. There is a high probability that the production of antibodies against antigens will not begin at all. During the first pregnancy, the process of their production (if it has begun) proceeds slowly. Decreased immunity due to shift hormonal levels and the slowness of white blood cells contribute to the fact that the Rh conflict either does not begin at all or is mild.

During second and subsequent pregnancies

When faced with foreign antigens, the body acquires “cellular memory”. This means that the next time it encounters a foreign antigen, the formation of antibodies in the female body will occur much faster. With each subsequent time, the speed of the process increases, increasing the inevitability of the development of Rh conflict.

Memorization occurs not only after a successful pregnancy, but also after a miscarriage, abortion, or medical intervention involving a blood transfusion.

If a Rhesus conflict has developed in the body of a young mother, modern medical methods are able to correct the situation in time. She is advised to constantly be under the supervision of specialists.

Consequences of negative Rh factor during pregnancy

A pregnant woman with negative Rh is required to take an antibody test every month. The obstetrician-gynecologist pays close attention to accompanying pregnancy with such a history. Until the thirty-second week, a venous blood test for the presence of antibodies is carried out every month. After the thirty-second week, it should be taken every couple of weeks. From 35 weeks - weekly.

Otherwise, bearing a baby by a mother with negative Rh is no different from the course of a normal pregnancy. The rapidity of antibody development determines whether immunoglobulin will need to be administered to the expectant mother.

Impact on baby's health

If not accepted preventive measures, dangerous pathological processes are launched:

1. A decrease in the number of red blood cells in the fetus, which are responsible for transporting oxygen, which gradually develops oxygen starvation. First of all, it affects the development of the heart and brain.
2. The amount of bilirubin increases. It is produced when red blood cells are destroyed. An increasing amount of bilirubin causes serious intoxication of the fetus.
3. Increased production of red blood cells by the spleen and liver of the child, causing an enlargement of these organs and their pathological development.
4. The development of an imbalance in the composition of the blood, impaired production of blood particles, the development of pathologies in the development of the spinal cord, congenital hemolytic anemia. Hemolytic disease of the newborn (HDN) is manifested by pale skin and general weakness.

Methods for diagnosing problems with negative Rh factor during pregnancy

The presence of antibodies in a young mother is determined at the very beginning of pregnancy. Many women know about their rhesus long before conception and the onset of " interesting situation" The obstetrician-gynecologist puts such a mother on special registration. Having identified negative result antibody test, the doctor prescribes a monthly venous blood donation for the expectant mother to monitor the rate of antibody formation. How closer date childbirth, the more often the young mother has to undergo tests to control the situation.

In addition to blood tests, the pregnant woman is prescribed routine ultrasound examinations, during which close attention is paid to the condition of the baby’s liver and spleen, as well as the condition of the placenta.

If any pathologies are detected, cardiotocography (CTG) and Doppler ultrasound are additionally performed. These studies make it possible to evaluate the functioning of the child’s cardiovascular system, as well as whether a sufficient amount of oxygen is supplied to him through the uteroplacental bloodstream.

If the analysis for anti-Rhesus bodies shows their rapid growth, invasive diagnostic methods. This diagnostic method is dangerous due to leakage of water surrounding the fetus, the risk of infection, and the formation of a hematoma on the umbilical cord.

Analysis amniotic fluid- the most reliable study, which indicates the exact amount of bilirubin produced by the baby, which allows us to assess the condition of the fetus. Taking material from the umbilical cord also provides reliable information about the composition of the fetal blood.

Specifics of childbirth

If the incompatibility of Rh factors did not lead to the rapid formation of antibodies and the pregnancy proceeded normally, without pathologies, the baby may be born naturally. During the process of delivery, the mother's body may intensify the production of antibodies due to the loss of a certain amount of blood. To do this, in the delivery room, the obstetrician-gynecologist must have on hand a portion of blood of the same type and Rh as that of the woman in labor. To eliminate the risk of pathologies during birth process a woman in labor is allowed to receive an injection of immunoglobulin.

In cases where the child inherited not the mother’s Rh, but the male, and a Rh conflict arose while carrying the baby, a decision is made to deliver by caesarean section. A problematic pregnancy is supported and maintained until 37-38 weeks, and upon reaching this period, a planned operation is performed.

In severe situations, a newborn baby is given a blood transfusion of the same type and Rh as the mother’s. A newborn is not fed in the first days breast milk, but mixtures. This is due to the fact that in mother's milk still contains antibodies. If they enter the baby's body, they will begin to destroy the red blood cells of his blood.

Immunoglobulin is injected into the body of a young mother within 72 hours after birth. This will prevent the conflict from developing in subsequent pregnancies. The same measures should be taken after an abortion or miscarriage. It is extremely important to complete the injection within three days.

Even if the first birth and gestation period passed without complications and the woman plans next pregnancy from a man with positive Rh, her body will still produce memory cells, so for the next birth the injection drug will need to either be purchased independently or to check its availability in the maternity hospital.

You can learn more about what Rh conflict is, why it is bad, and how pregnancy proceeds with such a history from the video:

Conclusion

Rh negative a mother does not have a reason to give up motherhood, and the incompatibility of Rhesus with her beloved man is not a reason to part with him. In the vast majority of cases, bearing a baby under such circumstances proceeds without pathologies. Rhesus conflict occurs in only ten percent of pregnant women. Serious problems with development and health status are observed in only two or three children out of a thousand.

Rh factor plays important role when planning pregnancy and bearing a child. For a successful pregnancy, a woman’s Rh factor is important, because she may face many problems and dangers that await her.

When a pregnant woman first visits a doctor and registers for pregnancy, the doctor must take blood for analysis.

For normal development and good health of the fetus in both parents should be same rhesus- positive or negative. However, nothing bad will happen if the father has a negative Rh factor, and the mother of the child has a positive one. And only if the mother is Rh negative, then this threatens the health, and even the life of the fetus.

Rh factor: when is it necessary to see a doctor?

If a woman has a negative Rh factor, the father’s blood must also be taken for analysis to determine his Rh factor. Best options For Rh negative woman there will also be an Rh negative man. But there is still a danger of Rh conflict; the child may take Rh positive, despite the “disadvantages” of the parents.

From the first weeks of pregnancy, women with a negative Rh factor come under close supervision of doctors and specialists due to their strong risk group.

So why is the difference in Rh factors between parents dangerous?

We will try to explain to you the risks of “minus” and how to avoid undesirable consequences and dangers.

There is no danger for Rh-positive mothers, even if the child has a negative Rh factor. It’s another matter when a Rh-negative mother has a Rh-positive child. There is a real threat of Rh conflict, and as a result - severe hemolytic disease of the fetus. The mother’s immune system reacts very violently to the baby’s red blood cells entering the mother’s blood; they are considered foreign to her, which causes the appearance of antibodies in the woman’s blood.

If the concentration of antibodies in a woman’s body is small, then pregnancy can proceed without complications for the mother and child. But if their number is too high, it can cause hemolytic disease of the newborn. This disease occurs as a result of the penetration of antibodies from the mother through the blood to the child. The child's liver and spleen become noticeably enlarged due to the fight against antibodies and replenishment of lost red blood cells.

During pregnancy, a woman should constantly monitor the growth of antibodies in the blood. Every month she takes a blood test, and from 28 weeks doctors take blood samples every 2 weeks. Under constant control The child's blood-forming organs are also located. Doctors with help ultrasound examination They check whether the fetus’s liver and spleen are enlarged, which can give a signal that the baby is unwell. Previously, in such cases, pregnancy was terminated, now there is a technique intrauterine transfusion blood.

There is a way to prevent the occurrence of Rh conflict in both the first and subsequent pregnancies. 2 weeks after the antibody test, and if they were not detected, the woman is given a vaccine called anti-Rhesus immunoglobulin, which prevents the appearance of antibodies in the mother's blood. It is administered intramuscularly at 27-28 weeks. After vaccination, a woman no longer needs to be tested for antibodies.

Development of Rh conflict between mother and fetus

If antibodies are found in a woman’s blood, but according to all tests and examinations they do not cause any harm to the child, then after birth, in order to prevent the appearance of antibodies in subsequent pregnancies, the woman is given immunoglobulin within 72 hours.

How do you know if a pregnant woman is at risk due to Rh negative?

Usually, during the first pregnancy, Rh conflict rarely occurs due to the low concentration of antibodies in the mother's blood. But with each pregnancy their concentration increases, and the risk of Rh conflict, and therefore undesirable consequences for the fetus, increases several times. Therefore, doctors prohibit women with a negative Rh factor from having abortions, especially during their first pregnancy.

It is very important for a woman with a negative Rh factor to carry her first pregnancy to term and give birth to a baby. If her first pregnancy ended in abortion, miscarriage, or a frozen pregnancy, then there is a serious risk of antibody growth in subsequent pregnancies. All this happens because after an abortion or miscarriage, mechanical curettage of the uterine cavity is necessary, as a result of which the blood of the fetus and mother are mixed. As a result, antibodies grow in the mother’s blood.

Rhesus negative woman After each pregnancy, immunoglobulin is administered, regardless of how the pregnancy ended - childbirth, abortion or miscarriage, in order to reduce subsequent risks.

According to studies, it was revealed that only 15% of people around the world have negative Rh.

What is the danger of hemolytic disease of the fetus?

When there is a Rh conflict between mother and fetus, hemolytic disease of the newborn occurs.

There is also a risk of group conflict when the mother has one blood type and the father another. Therefore, doctors are very interested in the blood type of the father and mother, and often prescribe AB0 tests for both after 32 weeks. As a result of such group conflict, the child may develop severe neonatal jaundice.

It is very important to determine the child’s blood type in time after birth in order to know whether it is different from the mother’s blood. If it is different, then the child may also develop hemolytic disease, although not in such a severe form as with Rh conflict.

Hemolytic disease is dangerous for a newborn due to the development of so-called kernicterus, when bilirubin in the child’s blood reaches prohibitive concentrations. With kernicterus, the baby's brain is affected, which leads to irreversible consequences in its further development. A timely replacement blood transfusion will help prevent kernicterus.

Everyone has heard about the Rh factor, which is present in the blood of every person, at least once in their life. It is a protein that coats red blood cells and is present in some people (about 85% of the world's population) and absent in others. In principle, Rh-negative men and women are no different from those around them, and such a feature of their body becomes fundamental only in two cases - if there is a need for a blood transfusion and pregnancy.

It is important to note that a negative Rh factor is not at all a contraindication for pregnancy, but all women with this feature should be aware of such a dangerous phenomenon as Rh conflict.

The Rh factor of the unborn child depends on the Rh factors of its parents, but it is impossible to establish it with 100% accuracy. However, there is a table by which it can be determined more or less accurately, and in addition, predict the risk of a conflict between the blood of the mother and the fetus.

Man	Woman	Child	Risk of conflict
+	+	75% +, 25% -	No
+	-	50% +, 50% -	50%
-	+	50% +, 50% -	No
-	-	-	No

Also, the cause of the conflict may be the blood groups of the future parents (or rather, the characteristic set of proteins that each of them has). The probability of its development can be determined from another table.

Man	Woman	Child	Risk of conflict
I	I	I	No
II	I	I, II	50%
III	I	I, III	50%
IV	I	II, III	100%
I	II	I, II	No
II	II	I, II	No
III	II	All groups	50%
IV	II	I, II, IV	66%
I	III	I,III	No
II	III	All groups	25%
III	III	I, III	No
IV	III	I, III, IV	66%
I	IV	II, III	No
II	IV	I, II, IV	No
III	IV	I, III, IV	No
IV	IV	II, III, IV	No

In percentage terms, the possibility of Rh conflict between mother and child is not so great (in fact, according to statistics, it occurs in less than 1% of pregnant women). But if it occurs, the situation will be so serious that future parents must undergo appropriate research and, even if minimal risk Be sure to consult a doctor.

A negative Rhesus mother can be dangerous for a “positive” baby only when his blood cells enter the mother’s blood. Her body reacts to them like any foreign body and immediately begins to attack them.

At first, they cause mild anemia in the fetus, but subsequently it simply does not have time to produce new red blood cells to replace the destroyed ones, which can lead to the development of serious diseases and pathologies:

• hemolytic disease, anemia;
• hepatitis and other liver disorders;
• CNS lesions;
• swelling and dropsy.

In the most severe cases, Rh conflict can cause miscarriage, death of the unborn baby in the womb, or stillbirth.

Video - pregnancy and Rh conflict: risks for mother and baby

When is the baby in danger?

A negative Rh factor during the first pregnancy usually does not pose any risk to the fetus, especially in cases where the pregnancy proceeds without complications. However, if this is the second pregnancy, or the woman’s history contains some unfavorable factors, then in these cases doctors talk about a phenomenon called sensitization.

That is, a certain amount of blood with the opposite Rh has already entered the mother’s bloodstream, her body is “familiar” with the child’s foreign red blood cells and has begun to produce dangerous antibodies to them. Sensitization usually occurs after:

• natural childbirth;
• ectopic pregnancy;
• caesarean sections;
• abortions and miscarriages;
• complicated pregnancies (placental abruptions, etc.);
• abdominal injuries during pregnancy;
• suturing the cervix (for example, when carrying twins);
• carrying out invasive procedures: cordocentesis, amniocentesis, etc.;
• in girls, sensitization sometimes occurs even before birth (in cases where blood cells from an Rh-positive mother enter her blood).

Such women are considered to be at risk, therefore, during the period of bearing a child, they need special control.

Every person in the world knows that abortion is dangerous. But with negative Rhesus they carry double risk, since due to sensitization all her subsequent pregnancies are automatically at risk.

How is Rh conflict diagnosed?

The danger of the situation also lies in the fact that when a critical mass of antibodies increases in the pregnant woman’s body, she practically does not feel anything, that is, she is unable to identify the changes occurring in her child. Sometimes the expectant mother may feel some discomfort, but usually it is attributed to an “interesting” situation.

Signs that the mother and baby have begun to have a Rh conflict can be determined using an ultrasound. In this case, the fetus experiences the following symptoms:

• accumulation of fluid in some body cavities;
• severe swelling;
• "Buddha pose" characterized by big belly and limbs retracted to the sides;
• enlargement of the heart and other organs;
• thickening of the veins of the placenta and umbilical cord.

To identify the risk to the fetus as early as possible and prevent all complications, even in the first stages of pregnancy expectant mother and the father must do a blood test to determine the Rh factor.

If the risk of conflict still exists, then over the next 9 months it will be constantly under the strict control of specialists. At approximately 18-20 weeks (if there have already been cases of Rh conflicts, then earlier), the pregnant woman will need to take another blood test, which should reveal the concentration of antibodies. A result (titer) of less than 1 to 4 is considered normal - in this case, doctors can say that there is no danger to the child. But even if the amount of antibodies in the blood is minimal, she will have to regularly visit the doctor, undergo all kinds of tests and monitor the baby’s condition. A repeat analysis is done at the beginning of the third trimester, after which the doctor decides on further tactics.

How to protect a child?

To alleviate the Rh conflict, nonspecific desensitizing treatment is recommended for all pregnant women (carried out at 10-12, 22-24 and 32-34 weeks), which consists of vitamin preparations, calcium and magnesium preparations, metabolic and antihistamines, oxygen therapy, etc. d.

If studies have shown that the antibody titer is high enough, the woman is given a special vaccine called anti-Rhesus immunoglobulin. It is able to neutralize antibodies that have already been developed in the mother’s body, due to which the risk to the baby’s health is significantly reduced. Typically, the first dose is administered between 28 and 34 weeks, and the second dose at least 3 days after birth in order to prevent the risk of Rh conflict during pregnancy. possible pregnancies in future.

In the most serious situations, the fetus requires an intrauterine blood transfusion to make up for the lack of blood cells destroyed by antibodies female body. If the pregnancy period exceeds 32-34 weeks, then doctors raise the question of an urgent cesarean section, since the constant “bombardment” of the child’s body with female antibodies can be dangerous for his life.

There are families who, as a result of this, unpleasant phenomenon several pregnancies ended in miscarriages, intrauterine fetal death or stillbirths. The only way out in such cases is the IVF procedure: fertilization of the egg takes place not in the uterus, but in a test tube, after which the embryos are examined for the presence of a certain gene and only those that have a negative Rh factor are implanted into the uterus.

Prevention of Rhesus conflict

Unfortunately, it is almost impossible for Rh-negative women to completely avoid conflict, but she can still take some precautions. First of all, she should take her health very seriously and, if a blood transfusion is necessary, be sure to inform the doctors about her negative Rh. In addition, abortion should be avoided if possible (especially if this is the first pregnancy) and great care should be taken during pregnancy to reduce the risk of complications such as placental abruption.

But even if the first pregnancy ended naturally and the child is absolutely healthy, she is in any case recommended to receive an injection of immunoglobulin, which can significantly reduce the risk of sensitization in the future.

Rh conflict during pregnancy: what should a woman with a negative Rh factor do to avoid consequences

Rh conflict during pregnancy occurs as a result of blood incompatibility according to the Rh system (Rh). According to statistics, this type of incompatibility occurs in 13% married couples, but immunization during pregnancy occurs in 1 in 10-25 women.

Pregnancy of a woman with a negative Rh factor, in which the fetus has a positive Rh factor, leads to the production of antibodies by the mother's immune system to the child's red blood cells.

As a result, the fetal red blood cells “stick together” and are destroyed. This is a humoral immune response to the presence of the Rh factor protein, which is foreign to the mother’s body.

• Rh factor - what is it?
• Probability of developing Rh conflict during pregnancy: table
• Causes
  • Feto-maternal transfusion
• Rh conflict during pregnancy: mechanism of occurrence
• Consequences for the child
• Risks
• Diagnosis, symptoms and signs of Rh conflict during pregnancy
• Treatment
  • Plasmapheresis for Rh-conflict pregnancy
  • Cordocentesis
• Immunoglobulin for negative Rhesus
• Can the Rh factor change during pregnancy?

What is Rh factor

To understand what Rh conflict is during pregnancy, you need to take a closer look at the concept of Rh factor.

Rh (+) is a special protein - an agglutinogen - a substance that can stick red blood cells together and damage them when they encounter an unfamiliar immune agent.

The Rh factor was first discovered in 1940. There are about 50 types of Rh antigens. The most mutagenic dominant antigen is D, which is found in the blood of 85% of people.

Antigen C is found in 70% of people, and antigen E is found in 30% of people on the planet. The presence of any of these proteins on the red blood cell membrane makes it Rh positive Rh (+), the absence makes it Rh negative Rh (-).

The presence of agglutinogen D has an ethnicity:

• among people of Slavic nationality, 13% are Rh-negative people;
• among Asians 8%;
• Among people of the Negroid race, there are practically no people with Rh-negative blood factor.

IN Lately Women with negative Rh factor blood are becoming increasingly common; according to the literature, this is associated with mixed marriages. Consequently, the frequency of Rh conflict during pregnancy in the population is increasing.

Inheritance of system D antigen

The types of inheritance of any traits are divided into homozygous and heterozygous. For example:

1. DD – homozygous;
2. Dd – heterozygous;
3. dd – homozygous.

Where D is a dominant gene, and d is a recessive gene.

Rh conflict during pregnancy - table

If the mother is Rh positive, the father is Rh negative, then one of their three children will be born Rh negative with a heterozygous type of inheritance.

If both parents are Rh negative, then their children will 100% have a negative Rh factor.

Table 1. Rh conflict during pregnancy

Man	Woman	Child		The likelihood of Rh conflict during pregnancy
+	+	75% (+)	25% (-)	No
+	—	50% (+)	50% (-)	50%
—	+	50% (+)	50% (-)	No
—	—	100% (-)		No

Causes

The cause of Rh conflict during pregnancy is:

• transfusion of incompatible blood according to the AB0 system is extremely rare;
• feto-maternal transfusion.

What is feto-maternal transfusion?

Normally, during any pregnancy (physiological or pathological), the mother enters the bloodstream Not a large number of fetal blood cells.

A negative Rh factor during pregnancy in a woman definitely poses a danger for a baby with a positive Rh factor. Rh conflict develops, just like any immunological reaction. At the same time, the first pregnancy can proceed without complications, but subsequent ones (second and third) lead to Rh conflict and severe symptoms of hemolytic disease of the fetus and newborn.

Mechanism of immunization (development of Rhesus conflict)

The Rh-negative mother and the Rh-positive fetus exchange blood cells, the immune system The mother perceives the baby's red blood cells as foreign proteins and begins to produce antibodies against them. For the development of a primary immune response, 35-50 ml of fetal red blood cells enter the mother’s bloodstream.

The volume of blood that flows from the baby's bloodstream to the mother increases during obstetrics. invasive procedures, caesarean section, childbirth, and other obstetric procedures.

The first immune response begins with the appearance of immunoglobulins M - these are large pentagram molecules (polymers) that hardly penetrate the placental barrier and do not destroy the red blood cells of the fetus, thus cannot cause harm to it. Therefore, the first pregnancy most often proceeds without consequences.

Secondary fetoplacental transfusion entails consequences for the child. It occurs during a repeat (second, third, fourth) pregnancy.

Cellular memory works in the pregnant woman’s body and, due to repeated contact with the Rh factor protein, protective antibodies are produced - immunoglobulins G - Rh conflict develops. Immunoglobulin G molecules are small monomers that can penetrate the placental barrier and cause hemolysis - the destruction of red blood cells of the fetus and newborn.

What contributes to the development of Rh sensitization?

The first pregnancy in an Rh-negative mother with an Rh-positive fetus in most cases ends successfully and ends with the birth of the fetus. Any subsequent pregnancy, regardless of the outcome (miscarriage on early stages, abortion, spontaneous interruption) in a Rh-negative woman becomes an impulse for the development of a secondary immune response and the appearance of immunoglobulins that destroy the baby’s red blood cells in utero.

The cause of Rh conflict during pregnancy in an Rh negative mother can be:

• In the first trimester:
  • medical abortion (surgical or medical), provided that these complications arose at 7-8 weeks.

Rh factor is a protein found on the surface of red blood cells. There are about fifty types of these proteins. If at least one of them is present in the body expectant mother, this means that her Rh factor is positive, and if it is absent, then it is negative. In this case, only the D antigen influences the occurrence of Rh conflict.

The fact that protein is present or, conversely, absent in the human body does not mean that he has any disease or pathology. It's simply a genetic trait, just like eye color, hair color, or blood type.

According to honey statistics, Rh negative is not so much common occurrence, it occurs in only 15% of people in the world. And yet, if a woman is Rh-, you need to be especially careful when planning a pregnancy, since every unsuccessful attempt may lead to serious Negative consequences for the opportunity to become a mother.

How does it affect conception and fetus in the future?

The Rh factor itself does not affect the likelihood and ease of conceiving a child, but the different Rh factor of the spouses will have an impact on how the pregnancy will proceed later. Thus, the most favorable case is considered to be the case when the Rhesus of both potential parents is the same, but this is not always the case. Conception will not happen faster just because the couple’s Rhesus coincides, since this process is influenced by a lot of factors, but pregnancy will be easier when the future father and mother are both Rh-positive.

Rh negative in husband and wife also significantly reduces the risk of problems in the future. When a child inherits a positive Rh from his father with negative group mother's blood may develop Rh-conflict disease.

We invite you to watch a video about the influence of the Rh factor on pregnancy:

Does the absence of antigen D in a mother affect pregnancy?

The immune system protects a person from infectious diseases and this happens due to the fact that the body’s antibodies destroy foreign proteins and antigens that have entered it.

If the mother’s blood is Rh-negative, then, as her future baby is Rh-positive, the woman’s body perceives the fetus as something foreign and hostile, which is why it begins an immune attack against it. In this case, red blood cells in the blood of the unborn baby are especially at risk, as they are literally destroyed. This phenomenon is called Rhesus conflict and, if nothing is done, this phenomenon can lead to very unpleasant consequences.

It should be understood that negative Rh in the mother is not an indicator that Rh conflict is inevitable.

If the woman and the future baby are Rh negative, these problems simply will not arise. And when the Rhesus of the mother and child do not match, it also does not always occur.

Is it possible to get pregnant with different or the same values?

If positive in women and men

This combination is considered the most optimal. Most often, with it, pregnancy occurs quickly and there are no conflicts during conception.

If mom and dad are negative

As a rule, there are no problems with the possibility of conception in this case either. If infertility exists, then it is not associated with negative Rh in both partners, but with some other reasons.

If the spouses are different

In this case, everything is not so clear. Most often when different rhesus with partners, a woman manages to get pregnant, although she can carry and give birth healthy child this does not always work out. In particular, the pregnancy of a Rh-negative mother with a Rh-positive child can lead to problems with pregnancy, but if the situation is the opposite, then no problems should arise. The body of a Rh-positive mother will not react negatively to a Rh-negative fetus..

What is Rh conflict in obstetrics, and why does it occur?

Rh conflict pregnancy - what is it?

In obstetrics, this concept is understood as any pregnancy accompanied by the production of antibodies directed against fetal cells. The Rh conflict itself develops in the same way as any other immunological reaction. It occurs due to the fact that the mother has a negative Rh factor and unborn child who is Rh positive, exchange blood.

In this case, the mother’s immune system regards the presence of the fetus in her body as a foreign threat and begins to produce antibodies against it. For this to happen, it is enough that 35-50 ml of red blood cells from the blood of her future baby enter the woman’s body. However, even if there is incompatibility between the blood of the mother and child due to the Rh factor, the Rh conflict itself does not always arise.

For example, it happens that during such a pregnancy antibodies may not be produced at all, or there may be so few of them that they cannot cause serious harm to the health of the unborn baby.

There are a number of factors that increase the occurrence of Rh conflict during gestation. And not all of these reasons are associated with the blood of her unborn child entering a woman’s body.

The more “bloody” the obstetric intervention was, the greater the risk of immunization. The same thing happens if there was no bleeding, but the placental barrier was broken.

• With a cesarean section, this risk increases by 52.5%.
• With manual separation of the placenta - by 40.3%.
• Antepartum hemorrhage increases it by 30%.
• And with eclampsia, when the placental barrier is disrupted, the risk is 32.7%.

We invite you to watch a video about what Rh conflict is during pregnancy:

Probability when expecting your first baby

The first pregnancy is considered relatively safe in terms of Rh conflict. The fact is that usually the placenta reliably protects the fetus from the effects of antibodies, and they themselves either do not have time to be formed, or, if they are produced, then in very small quantities. To put it simply, the mother’s body doesn’t seem to notice developing fetus, and therefore the production of antibodies does not occur until the child’s blood begins to mix with the woman’s blood.

At normal course pregnancy, this usually happens during childbirth.

The likelihood of a baby coming into contact with antibodies produced by the body of his Rh-negative mother is extremely low, although possible. In general, the occurrence of Rh conflict during the first pregnancy is not frequent and is approximately 10%.

Probability when carrying a fetus for the second time

During the second and subsequent pregnancies, the likelihood of Rh conflict increases significantly. This is explained by the fact that a Rh-negative woman already has time to develop immune memory, which leads to enhanced education antibodies to the D antigen contained in the blood of her Rh-positive baby.

The second and any subsequent pregnancies, regardless of how they proceeded and how they ended, become a catalyst that triggers the production of antibodies in the mother’s body.

However, this does not mean at all that a woman who has given birth to one child can no longer become pregnant, since this will certainly lead to an Rh conflict. A woman just needs to be more careful and responsible about controlling antibodies.

And the first thing that is required is not to refuse an injection of anti-Rhesus immunoglobulin when prescribed by the attending obstetrician-genecologist, if you plan to carry and give birth to your second baby healthy. This will allow the binding of foreign Rh-positive antigens and prevent the production of antibodies in the mother’s body, which significantly reduces the risk of complications during a subsequent pregnancy.

If antibodies were not produced during the first pregnancy, and immunoglobulin serum was administered on time, then when carrying a second baby, the probability of an Rh conflict will be equal to the same initial 10%.

What is the danger when a conflict develops?

Rh conflict can be very dangerous during pregnancy, since antibodies seriously attack the fetus’s body and destroy its red blood cells. In case of Rhesus conflict, massive destruction of red blood cells is observed, due to which a large amount of bilirubin, which has pronounced toxic properties, is released into the blood.

As a result, all organs and tissues of the fetus are damaged, but the nervous system a baby, for example, the tissues of his brain soften, which can lead to mental retardation. The spleen and liver, the main purpose of which is to rid the body of bilirubin, do not cope with their function. And the massive death of red blood cells itself leads to the baby developing anemia and hypoxia.

All these three factors, launched together, lead to a serious complication - hemolytic disease of the fetus.

The consequences of complications - hemolytic disease of the fetus can be:

As for the Rh-negative mother, who has become the unwitting culprit of all these troubles, the Rh conflict itself will most likely not affect her health in any way, even if the developing fetus suffers from this. serious pathologies.

Sometimes, but not always, with a Rh conflict, the expectant mother may develop preeclampsia, which is a truly serious complication.

We invite you to watch a video about the dangers of Rhesus conflict:

Why can't abortions be done?

Why can’t a mother’s pregnancy be terminated if she has a negative Rh?

Doctors do not recommend women with negative Rhesus to have abortions, except perhaps medical indications, but even in this case, it is advised to think carefully before making such a decision. With each subsequent pregnancy, antibodies in a woman’s body are produced at an ever-increasing speed and in ever-larger quantities. And the possibility of a successful gestation of the fetus decreases significantly with each termination of pregnancy.

Parental blood group compatibility chart

What to do for prevention?

Even at the stage of pregnancy planning, a woman needs to have a blood test done in order to determine her group (if this has not been done before) and Rh status. If the potential mother is Rh negative, it will be necessary to find out the Rhesus affiliation of the future father. This should be done before pregnancy in order to keep the formation of antibodies under control from the very beginning.

It is advisable, even at the planning stage, to obtain specialist advice regarding the possible risks of Rh conflict occurring during gestation and its possible outcome.

In this situation, it is important to treat family planning methods with all possible responsibility.

That is, do not have abortions and try to preserve the first pregnancy as much as possible. And from the very beginning, from about 7-8 weeks, It is recommended to register and be observed by a doctor so that in case of complications associated with a negative Rh factor, the expectant mother was promptly provided with the necessary assistance.

Get everything necessary appointments on the part of the observing obstetrician-gynecologist, including mandatory vaccination with human immunoglobulin anti-rhesus rho(d).

To summarize, I would like to say that the negative Rh factor itself is not nearly as scary as it might seem. It is not always the cause of Rh conflict, but it is advisable to take care of its prevention as early as possible - preferably even at the stage of pregnancy planning. Only in this case will it be possible to reduce the likelihood of complications to a minimum.