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The Rh factor is a special protein that is found on erythrocytes - red blood cells. If it is not present, they speak of a negative Rh blood factor (Rh-); if it is present, it is said to be positive (Rh+). Problems during pregnancy can arise when a woman is Rh negative and the future father is Rh positive. In this case, the woman’s immune system may not “accept” the child and begin to get rid of the “stranger.” This is the Rh conflict during pregnancy.

Coincidence

All expectant mothers need to know that only an Rh-negative woman can face Rh conflict. In addition, several other circumstances must coincide:

The husband must be Rh positive;

The child must inherit the father's Rh factor (the probability of this is 50%).

In most cases, this should not be the first pregnancy.

Rhesus conflict usually does not appear during the first pregnancy. The immune system does not have time to recognize the threat, since it encounters a foreign protein for the first time. Only cellular memory is formed. But having remembered the “stranger,” the next time he appears, the woman’s immune system will begin to defend itself and produce aggressive antibodies. When they reach an unborn child, they can destroy his red blood cells. Therefore, Rh-negative wives of Rh-positive husbands who have already given birth to an Rh-positive child automatically fall into the risk group. The likelihood of Rh conflict with next pregnancy is also high in women whose previous pregnancy was terminated after 8 weeks, when cellular memory had already formed.

Rh conflict during pregnancy: table by blood groups

The table below shows the likelihood of Rh conflict during pregnancy depending on the Rh factor of the future parents.

Rh conflict during pregnancy: consequences for the child

There is no Rh conflict between mother and fetus for a woman’s body negative consequences does not have. He only threatens the unborn child. Antibodies destroy his red blood cells, hemoglobin breaks down and bilirubin is released. In large quantities, bilirubin is very toxic to all organs, but especially to the brain of the unborn child. A small amount of hemoglobin, that is, red blood cells, is fraught with hypoxia and anemia, because red blood cells supply the blood with oxygen.

Rh conflict during pregnancy: symptoms

Before the 20th week of pregnancy, Rh conflict appears very rarely. As a rule, Rh conflict symptoms during pregnancy appear closer to the 28th week of gestation. Ultrasound determines the so-called ultrasound markers - polyhydramnios and placental thickness. If the placenta is thicker than expected for the duration of pregnancy, this may be a sign of beginning hemolytic disease, that is, Rh conflict during pregnancy. The circumference of the future baby’s abdomen, the presence of abdominal cavity fluid, enlarged liver and spleen. If they are enlarged, these organs may begin to produce young red blood cells instead of destroyed ones. Another symptom is a decrease in blood flow speed in cerebral artery baby. This indicator is measured using Doppler ultrasound.

To prevent such serious complications, when a woman first consults a doctor about pregnancy, she is given a referral for a blood test to determine the Rh factor and blood type. If Rh is negative, and the expectant mother does not know her husband’s Rh factor, he will also have to be tested to determine the Rh factor and blood type. If Rh is positive, the woman will be taken under special control.

This means that simultaneously with determining the negative Rh factor, the laboratory will also determine the titer of antibodies in the woman’s blood - their amount in 1 ml of blood serum. The higher the titer, the more antibodies in the mother’s bloodstream. Only a titer above 1:16 matters. But even with a very high titer, fetal disease does not always manifest itself.

If an antibody titer is detected, the test is repeated once a month until the 20th week of pregnancy, and if it increases rapidly - once every 2 weeks. In this case, ultrasounds from the 20th week are done every 4 weeks to monitor the symptoms of hemolytic disease in the unborn child.

If at least one symptom of hemolytic disease is found in the unborn baby, the woman will be hospitalized in a specialized hospital. If the antibody titer increases rapidly, the woman will undergo a puncture of amniotic fluid to determine the severity of the hemolytic disease in the baby. At the same time, it is decided whether cordocentesis is needed - sampling cord blood to determine the level of hemoglobin in the child’s blood. If the level is low, an intrauterine blood transfusion is performed. Then the antibody titer will be determined once a week. Such measures alleviate the baby’s condition, but do not cure the disease. You can get rid of it only after birth.

Rh conflict: consequences for the child after birth

Treatment for Rh conflict during pregnancy is carried out until 34-36 weeks of gestation. After this period, doctors will try to bring the baby closer to birth. It is believed that caesarean section in such cases the best way the birth of the baby, but it all depends on the condition of the child. Rhesus conflict in itself is not absolute indication to the operation.

After birth, the baby is treated for anemia and other manifestations of hemolytic disease. Bilirubin levels are also monitored daily.

Prevention of Rh conflict during pregnancy

If the blood is Rh negative expectant mother antibodies are not detectable, at the 28th-30th week of pregnancy she will be given an injection of anti-Rhesus immunoglobulin. If a Rh-positive baby is born, then during the first 48-72 hours after birth the mother is also given an injection of anti-Rhesus immunoglobulin. This will help prevent conflict in your next pregnancy. The same injection is also needed after a miscarriage or abortion after 8 weeks, as well as during an ectopic pregnancy. It is also necessary after invasive diagnostics - chorionic villus biopsy, amniocentesis or cordocentesis, for abdominal injuries during pregnancy and bleeding or placental or chorionic abruption.

Blood type conflict

Rh conflict during pregnancy should not be confused with blood group conflict. In this case serious problems This usually does not affect the baby’s health. The table below shows the likelihood of such a conflict occurring. Group conflict manifests itself only after childbirth in the form of hemolytic jaundice. Usually on the 5th day everything returns to normal. Unlike Rh conflict, group conflict usually manifests itself after the first birth. After the second and subsequent births it occurs much less frequently.

Mother	Father	The child will inherit	Risk of group incompatibility
0 (I)	0 (I)	0 (I) probability 100%	No
0 (I)	A (II)	0 (I) or A (II) probability 25/75	75%
0 (I)	B (III)	0 (I) or B (III) probability 25/75	75%
0 (I)	AB (IV)	A (II) or B (III) probability 50/50	100%
A (II)	0 (I)	0 (I) or A (II) probability 25/75	No
A (II)	A (II)	0 (I) or A (II) probability 10/90	No
A (II)	B (III)	0 (I), A (II), B (III) or AB (IV) probability 10/20/20/50	70%
A (II)	AB (IV)	A (II), B (III) or AB (IV) probability 50/15/35	50%
B (III)	0 (I)	0 (I) or B (III) probability 25/75	No
B (III)	A (II)	0 (I), A (II), B (III) or AB (IV) probability 10/20/20/50	70%
B (III)	B (III)	0 (I) or B (III) probability 10/90	No
B (III)	AB (IV)	A (II), B (III) or AB (IV) probability 15/50/35	50%
AB (IV)	0 (I)	A (II) or B (III) probability 50/50	No
AB (IV)	A (II)	A (II), B (III) or AB (IV) probability 50/15/35	No
AB (IV)	B (III)	A (II), B (III) or AB (IV) probability 15 /35 /50	No
AB (IV)	AB (IV)	A (II), B (III) or AB (IV) probability 12/25/50	No

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

Conflict of Rh factors

Rh factor is an immunological property of blood that depends on the presence of a special type of protein, has no effect on the body and is transmitted hereditarily. The presence of antigen in erythrocytes (85% of the population) is a positive Rh factor, negative Rh factor(15%) – absence of antigen in red blood cells. The Rh factor does not change throughout life.

A conflict of Rh factors only manifests itself in the case of direct blood contact, which is possible during pregnancy if the mother has Rh negative blood and the fetus inherited Rh positive from the father. Rhesus conflict does not develop when Rhesus negative child carried by mother with Rh positive.

Antibodies formed in a woman’s blood as a result of Rh conflict are present in her throughout her life. They are produced in every case of contact with Rh- negative blood women with any Rh-positive blood, enhancing the immune response. That is why Rh conflict may not appear during pregnancy if it is the first. Sometimes problems arise on recent months first pregnancy, but usually they are minor. With each subsequent pregnancy immune reaction the mother intensifies as more and more antibodies are produced to the positive Rh factor of the fetus. Penetrating through the placenta into the blood of the fetus, antibodies cause hemolytic disorder– Rhesus conflict. Its consequences may be:

Spontaneous termination of pregnancy at different stages;
Premature birth;
Stillbirth;
Jaundice in newborns requiring blood transfusion.

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

Rhesus conflict, symptoms

The Rh conflict with her fetus does not affect the body of an 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.

In case of Rh conflict, symptoms of hemolytic disease of the fetus are detected on ultrasound and can 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 is the result of soft tissue swelling;
Thickening of the placenta and increase in the diameter of the umbilical vein due to placental edema;
The fetus, instead of the “fetal position,” takes on the “Buddha pose” - the limbs are moved to the sides from the tummy enlarged by accumulated fluid.

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

In the most difficult cases Rhesus conflict develops hydrops fetalis and edematous syndrome of the newborn, which can lead to stillbirth or death of an already born child.

Rh conflict during pregnancy

If the expectant mother has a negative Rh factor 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 before 28 weeks from conception, when antibodies may 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;
Obtaining Rh-positive blood through transfusions;
Undergoing invasive prenatal tests - amniocentesis, chorionic villus biopsy.

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

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

How to reduce Negative consequences resolves Rh conflict for the unborn child qualified specialist, taking into account the results of blood tests of the expectant mother and the condition of the fetus. The use of the following treatment and preventive measures individually or in combination makes it possible to give birth healthy child for Rhesus conflict:

Vaccination of the mother with anti-Rh immunoglobulin in all cases of contact of her Rh-negative blood with Rh-positive blood (after abortion, previous births, miscarriages). The drug binds the formed antibodies and removes them from the body;
Preventive vaccination with anti-Rhesus immunoglobulin for a pregnant woman in current pregnancy, starting from the 28th week, or within 72 hours after bleeding, amniocetosis;
Cordocentesis is an intrauterine blood transfusion through the umbilical cord to the fetus;
Activation premature birth, according to the condition of the fetus;
Exchange blood transfusion for a newborn;
Phototherapy of a newborn under special blue lamps.

The pledge of birth healthy baby with Rh-positive blood from a Rh-negative mother, it is timely to contact antenatal clinic, better still at the pregnancy planning stage. A qualified physician will determine necessary measures prevention of the development of Rhesus conflict.

Incompatibility between mother and fetus, which is based on defensive reaction female body: Rh positive blood of a child cannot exist with Rh negative mother. This is a very serious phenomenon, since Rh conflict leads to fetal death, artificial termination of pregnancy and stillbirth child.

The Rh factor of human blood is determined by the presence of D-agglutinogen in the Rh system. This special type of lipoprotein is located on the top of red blood cells. This item is present in the blood of 85% of the planet's inhabitants, but 15% do not have such a lipoprotein, and therefore are Rh negative group. Experts have developed a classification system for the Rh factor depending on the blood type and its Rh factor; a positive Rh factor is designated Rh (+), and a negative Rh factor is designated Rh (-).

Rh conflict during pregnancy occurs exclusively in women with a negative Rh factor. A child can inherit Rh positive paternal blood, which is where all subsequent problems arise. The mother's body perceives the child as a virus and directs all its forces to fight it. Rh conflict between mother and fetus is not observed when the patient has Rh (+), and the pregnant child and his father have Rh (-). The decisive role is played by the indicators of the maternal Rh factor of the blood.

Rhesus conflict during the first pregnancy does not pose a big threat to the life of the baby, because the maternal immune system does not yet produce enough rhesus bodies, but problems can arise during pregnancy. later pregnancy. At every next conception The child's immune system will increase the amount of antibodies against the fetal Rh factor. It is these antibodies that penetrate the child’s blood and provoke a phenomenon called Rh conflict.

Today's advances in the field of immunology significantly reduce the risks associated with incompatibility between a woman and her baby.

What is Rh conflict during pregnancy?

The process of Rh-positive and Rh-negative red blood cells sticking together is called agglutination. It is precisely this phenomenon that is fought by antibodies connected to the Rh protein - immunoglobulins. These antibodies have only two types: IgM and IgG.

Contact of maternal antibodies with the baby's red blood cells is observed in the cavity between the placenta and the uterine wall. Initially, during a hematological collision, antibodies of the IgM type are produced, which are large enough to prevent them from penetrating to the fetus through the placenta. Therefore, Rh conflict during the first pregnancy is quite a rare occurrence. But when the baby’s positive molecules re-enter the woman’s blood, the active production of type 2 antibodies begins - IgG. Their size is much smaller, so they can easily penetrate the placenta and destroy the baby’s red blood cells. The presence of such processes in the body causes the development of hemolytic disease of the newborn. Therefore, Rh conflict during the second pregnancy carries serious threat for the life of a child.

If the first pregnancy proceeded without complications, and immunoglobulin was introduced into the body on time, then there should be no problems with the second pregnancy either. You should not be afraid ahead of time and worry about a negative Rh factor, since it is not a contraindication for conceiving a child. It’s just that Rh-conflict pregnancy should proceed under the supervision of specialists, and expectant mother must be extremely careful in everything.

Causes of Rh conflict

The following factors can provoke this phenomenon:

Blood with a positive Rh factor of the child enters the mother's blood of negative Rh factor at the time of the birth of the child, which activates the further production of antibodies in the female body. Once formed, antibodies remain in the body for life.
The blood of the patient and the fetus, incompatible with Rh factors, can combine during a pathological course of pregnancy: the development of a fertilized egg outside the uterus, surgical intervention, spontaneous abortion, bleeding, Rh positive blood transfusion. All of the above factors are possible reason the occurrence of serious problems during subsequent pregnancy.
The production of antibodies in the female body is influenced by early prenatal tests: amniocentnesis, chorionic villus biopsy. To obtain the test material, intrauterine intervention is necessary, which creates the possibility of Rh-positive fetal blood entering the mother’s blood.

Experts also identify a group of risk factors not related to pregnancy and childbirth, which significantly increases the chance of Rh conflict between mother and child:

production of antibodies during blood transfusion of positive Rh factor;
immunization at intravenous administration narcotic substances one needle for everyone.

Symptoms of Rh conflict during pregnancy

Rhesus conflict between mother and child is not clear severe symptoms. The presence of hemolytic disease can be detected by undergoing an ultrasound. During the examination, the doctor will be able to identify the accumulation of fluid in the abdominal cavity, which provokes an uncharacteristic enlargement of the tummy. There may also be an abnormal increase in vital important organs: liver, spleen, heart. The manifestation of certain symptoms indicates the development of a certain form of hemolytic disease in the child. Experts distinguish three types of disease: edematous, icteric, anemic.

Development of this disease It has serious consequences and can cause the death of a child in the womb from the 20th week of pregnancy.

Symptoms of complicated Rh conflict during pregnancy

The degree of complexity of the hemolytic disease depends on the number of produced anti-Rhesus bodies with Rh (-) in the mother’s blood and on the level of development of the fetus. Serious complication is the formation of hydrops fetalis, the development of edematous syndrome in the baby and pathological increase weight of the fetus, which leads to its death.

Diagnosis of Rhesus conflict

Diagnosis consists of examining the female body and identifying risk factors possible development hemolytic disease. By registering, every pregnant woman and father of the unborn child mandatory They take a blood test to determine your blood group and Rh factor. If a woman has a negative Rh factor and the father has a positive one, it is necessary to donate blood once a month to study antibodies and monitor their development.

When antibodies are initially detected, their class of manifestation must be determined. After the 20th week of pregnancy, the patient must be examined by a specialist, who will determine the method and date of the upcoming birth.

After the 18th week of pregnancy, the condition of the fetus is examined using ultrasound. You can assess the child’s condition and level of development using the following methods:

Non-invasive:
- An ultrasound examination is performed to determine the presence of pathologies in the fetus, the size of its organs, the diameter of the umbilical vein, and the thickness of the placenta are studied. In a normal pregnancy, ultrasound is performed 3 times: at 18-20 weeks, 30-32 weeks and just before birth at 34-36 weeks. If the child’s condition is not normal or the baby has had a blood transfusion, then an ultrasound examination can be performed every day;
- Dopplerometry; a method that evaluates the functionality of the heart muscle, blood supply indicators large vessels and umbilical cord;
- cardiotocography; sent for examination of cardio-vascular system, which also helps to timely determine the lack of oxygen in the fetus.
Invasive:
- amniocentesis: intervention in amniotic sac in order to obtain material amniotic fluid with further research in the laboratory. To evaluate general state child, the presence of bilirubin is examined. The method is very accurate, but, unfortunately, it carries great danger: an infection can get into the amniotic sac; intervention can lead to premature birth and bleeding. Amniocentesis is prescribed to women whose previous births were accompanied by hemolytic disease baby.
- cordocentesis: blood sampling that involves puncture of the umbilical cord. This method used in cases where it is necessary to give a blood transfusion to a child and determine the severity of hemolysis as accurately as possible. Complications after the procedure are the same as with amniocentesis, however, a hematoma may develop on the umbilical cord, and bleeding may occur at the site of umbilical cord puncture. Cordocentesis is prescribed to women who have had Rh conflict during previous pregnancies. If at ultrasound examination symptoms of hemolytic disease were detected, and the amount of antibodies produced exceeds the norm, then it is also necessary to perform cordocentesis.

Complications after use invasive methods Diagnoses of Rh conflict between mother and fetus can be very serious, so everything possible must be done to avoid intrauterine intervention. The woman must be counseled and explained the risk to which the fetus is exposed. The doctor cannot be held responsible for the behavior of the female body and the successful completion of the procedure, so the patient is often writing gives his agreement for the further application of the procedures.

Treatment of Rh conflict during pregnancy

Modern therapeutic techniques make it possible to effectively and quickly eliminate the threat to life for the fetus, preserving its life and supporting normal indicators pregnancy. The most effective method What remains is a fetal blood transfusion, which is prescribed if the child develops anemia. Intervention occurs only when inpatient treatment, and after the procedure the woman still long time remains in storage, under the careful supervision of obstetricians. Blood transfusion improves the condition of the fetus and prevents premature birth, and the risk of developing a hemolytic disease in the newborn is also significantly reduced.

Women whose antibodies were detected on early stages or previous pregnancy accompanied by Rhesus conflict between mother and fetus, belong to the group with increased risk complications. Until the 20th week, patients must regularly visit the women's office, and after that they are sent to inpatient treatment.

Treatment may also be based on the purification of maternal blood. For this purpose, procedures such as plasmapheresis or hemosorption are used. The patient's immunity can be weakened using desensitizing therapy and immunoglobulin treatment. However, statistics indicate the ineffectiveness of these methods, so they were actually completely abandoned.

It is possible to achieve normalization of the child’s condition only by stopping the access of antibodies of the maternal immune system, therefore, as soon as medical indicators allow the child to survive outside the mother’s womb, delivery is carried out. Rh-conflict pregnancy usually ends in premature birth, since in the last stages anti-Rhesus bodies reaching the child are produced in more. The methods and timing of delivery depend on the individuality of the female body and the severity of the fetal condition. Caesarean section is considered the most gentle method, which is why it is the most common way of delivering a baby. If the patient has reached 36 weeks of pregnancy, then obstetricians can induce labor, which will take place naturally, but a little earlier than planned.

Prevention of Rh conflict during pregnancy

To prevent the development of hemolytic disease, the expectant mother is given anti-Rhesus immunoglobulin D. This is very effective drug, which has undergone a number of studies and is produced at enterprises in the USA, France and the Russian Federation. The drug is administered at the twenty-eighth week of pregnancy, because it is at this period that there is an increase in the risk of developing Rh conflict between mother and fetus. Reuse The drug must be administered within three days after delivery.

The injection can be prescribed regardless of the initial result: childbirth, artificial termination of pregnancy, abortion, ectopic pregnancy etc. If during any of the operations the patient has lost a large amount of blood, the dose of immunoglobulin should be increased.

When registering, a woman undergoes tests to determine the Rh factor of the blood; if the results show that it is negative, then it is necessary to establish the Rh factor and the father of the child. If a man has a positive Rh factor, then the fetus may inherit his Rh factor, which can provoke an Rh conflict with the mother. In this case, the pregnant woman is regularly examined and the amount of anti-Rhesus bodies produced is checked. If antibodies are not detected, then the child is not in danger. Immediately after birth, the baby's blood is taken for analysis and determination of the blood type and Rh factor. If the result indicates that the baby has Rh positive blood, the mother is also given immunoglobulin D to prevent the possibility of Rh conflict occurring during future pregnancies.

Most experts are inclined to believe that immunoglobulin should also be administered after a blood transfusion with a positive Rh factor or platelet mass, placental abruption, injury to the expectant mother, or chorionic villus biopsy.

The desired addition to the family is a great happiness, but sometimes the process of bearing a future baby can be overshadowed by unpleasant news from the mother’s own body. Women are especially worried if there is a discrepancy between the Rh factors of the baby’s parents, because in such a situation it can appear, which can negatively affect the formation of the fetus or even cause the loss of the child.

When doctors still knew nothing about blood groups and the existence of the Rh factor, sudden spontaneous abortion or premature birth, a stillborn child or a newborn with severe pathologies were explained for various reasons, A real ways there was simply no way to influence the situation.

Nowadays, everyone is well aware of the role of blood groups during transfusion and the Rh factor during intrauterine development. What is the Rh factor and why is it so important?

The Rh factor is a special type of protein, an antigen, located on the surface of red blood cells. blood cells- red blood cells. The vast majority of the world's population is Rh-positive, that is, these people have this specific antigen. The same part of the population in whose blood the Rh factor is not detected is considered Rh negative.IN ordinary life it has almost no effect on normal functioning person.

Problems with the Rh factor can manifest themselves when blood with positive and negative values interacts.

This occurs during blood transfusion and during pregnancy, when the blood of the woman and the fetus are different meanings. The presence of blood with a different meaning is perceived by the human immune system as an invasion foreign bodies, so it attacks “foreign” blood cells, producing antigens that destroy the “aliens”. A so-called Rh conflict arises. This condition can be very dangerous, but during the first pregnancy it can rarely harm the fetus, since by the time a threatening amount of antibodies is formed, pregnancy ends successfully with delivery. But Rh conflict during the second pregnancy poses a real threat.

Interestingly, this condition only occurs if the mother has Rh negative blood and the fetus receives the blood of an Rh positive father. In the opposite situation, when the mother is Rh positive and the fetus has inherited negative paternal blood, no conflict occurs and the pregnancy develops normally, there is no risk for the child of developing hemolytic disease. This condition will also not affect the development of pregnancy in any way.

Carrying out diagnostic activities

Rh conflict occurs when the mother has Rh-negative blood, and the fetus has inherited the paternal variant, that is, Rh-positive blood. During the first pregnancy, there is practically no threat of the connection of the blood of the mother and the fetus and its appearance, since this requires the penetration of maternal blood through the wall of the uterus and placenta into the bloodstream of the fetus.

In the natural state this cannot happen, but there is a risk in the following cases:

At .
When conducting amniotic fluid testing and other invasive procedures, when the blood of the mother and child may mix.

At the birth of a child or when performing caesarean section, manual separation placenta, artificial abortion and other interventions, blood contact is inevitable. This suggests that the mother is now sensitized to the positive blood of the fetus, and Rh conflict in a second pregnancy is very likely to occur.

In order to minimize risks, a woman needs to undergo the following types diagnostics:

. After the first pregnancy, a woman already knows what the threat of Rh conflict is and is aware of the existing problem. If the child is from another man, it is necessary to perform a blood test to identify the Rh factor. If it is negative, like his wife’s, there is nothing to worry about, but a positive one can cause unpleasant consequences. Tests need to be done as early as possible, since the sooner the problem is identified, the greater the chances of successfully dealing with it. In addition to Rh, the antibody titer is also detected - the higher it is, the more risks development of hemolytic disease in the fetus.
. It is carried out in several stages, allowing you to detect characteristic features conflict: double contour of the head, enlarged abdomen, heart and edema umbilical veins, characteristic “Buddha pose”.
Doppler. This study allows you to examine the condition of the blood vessels of the fetus and placenta.
CTG (cardiotocography). Research examines the heart and vascular system fetus, revealing hypoxia - lack of oxygen in the blood.
Amniocentesis. This invasive technique represents a sample amniotic fluid to determine the level. The test is risky and has contraindications and side effects.
Cordocentesis. This is a puncture umbilical vein and a blood sample from it. This method helps diagnose the most early stages hemolytic disease. Like amniocentesis, it can be a dangerous procedure, as it threatens the mother’s blood entering the vessels of the placenta, and from there into the bloodstream of the unborn child’s body.

The danger of Rh conflict for the fetus

The later the Rh conflict is detected, the greater the chance that the child may be born sick and suffer from hemolytic disease of the newborn.

This disease can appear at the birth of the fetus or develop suddenly against the background of a completely successful development of the baby. If the baby is not provided with timely emergency assistance, he might die. Anyway, internal organs the child could be seriously harmed.

Hemolytic disease of newborns manifests itself in three degrees:

Jaundice.
Edema.
Anemic.

The most dangerous option is the development of an edematous form of the disease. In this case, all the child’s organs suffer, and it is very difficult to treat. The most common condition is moderate - icteric form diseases. Main danger diseases - his sudden appearance and rapid development, if at this moment the parents are not around, they are confused and cannot take action, or the problem occurs at night, the baby has practically no chance of survival.

An overabundance in a sick child often leads to damage to vital organs, including, which leads to a delay mental development and even the death of a child. Miscarriage or intrauterine fetal death also often occurs.That is why early diagnosis and timely adoption of measures to treat the consequences of Rh conflict are so important.

More information about Rhesus conflict can be found in the video:

If opposite blood values of the mother and fetus are detected, doctors usually carry out delivery ahead of time, since in this case, with each extra day of gestation, the risk of getting large quantity antibodies from mother to fetus are constantly increasing. Incompatibility does not always manifest itself in an overly pronounced, violent reaction, and therefore may not pose too much of a threat to the newborn. In such a situation, even treatment is not always necessary.

After the baby is born, he is most often placed under a blue lamp. Phototherapy sessions help cure hemolytic disease or prevent its development and relieve its symptoms. They treat already sick children in exactly the same way, plus they add the necessary drug treatment, blood transfusion and other methods aimed at saving the baby’s life.

The most effective and radical means To prevent the development of hemolytic disease of the newborn immediately after childbirth or sudden termination of pregnancy, premature birth is considered to be a blood transfusion into the umbilical vein.

Typically this manipulation is performed if previous pregnancy the child suffered from a hemolytic disease or died from it, as well as with an existing antibody titer of 1:32. In this case, the Rh conflict during the second pregnancy can be neutralized.

It is also practiced to administer a specific anti-Rhesus immunoglobulin to a mother who has given birth to her first child with Rh-conflict within the next 72 hours after birth.

It destroys fetal blood cells that have entered the mother's body and significantly reduces the risk of conflict during the next pregnancy.

Anti-Rhesus immunoglobulins are also administered during pregnancy if there is a threat of miscarriage or fetal death, and this procedure is also done during the first pregnancy.Most often this is caused by the possibility of blood mixing during invasive tests and tests, as well as if the pregnant woman had difficulties carrying the pregnancy.

Breastfeeding with Rhesus conflict

When to register different blood mother and child, doctors have different views on putting a baby to the breast. There is no clear information about how this affects the newborn. Although it can be assumed that the Rh conflict may affect penetration into breast milk, there is no confirmation of this.

After childbirth, doctors most often advise refraining from breastfeeding for some time in order to remove potentially dangerous antibodies from the mother’s body. Other experts no less firmly believe that breast milk, especially colostrum, is vital for the health and immunity of the baby. They say that as long as the mother's nipples are not damaged and there is no threat of blood entering the digestive tract child, breast-feeding cannot harm the baby's health.

Attentive attitude to your own health and the future of the baby, early registration and timely completion of all tests will protect the child from the manifestation of Rh conflict or stop the disease at the earliest stages. If mother and father know about existing risks, even if after birth the child is outwardly fine, they will closely monitor his condition and will be able to promptly prevent the development of dangerous consequences blood conflict.