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The Rh factor is a special protein that is found on erythrocytes - red blood cells. If it is not there, they talk about the negative Rh factor of the blood (Rh-), if it is - about the positive (Rh +). Problems during pregnancy can occur when a woman is Rh negative and the future dad 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 Rhesus conflict during pregnancy.

Coincidence

All expectant mothers need to know that only an Rh-negative woman can face an Rh conflict. In addition, there are a few other things that must match:

The husband must be Rh-positive;

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

Pregnancy in most cases should not be the first.

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

Rhesus conflict during pregnancy: table by blood types

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

Rhesus conflict during pregnancy: consequences for the child

Rh-conflict of mother and fetus for a woman's body is not negative consequences does not have. It 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 an unborn child. A small amount of hemoglobin, that is, red blood cells, is fraught with hypoxia and anemia, because red blood cells supply oxygen to the blood.

Rhesus conflict during pregnancy: symptoms

Before the 20th week of pregnancy, the Rh conflict is very rare. As a rule, Rh-conflict during pregnancy, symptoms appear closer to the 28th week of bearing a baby. On ultrasound, the so-called ultrasound markers are determined - polyhydramnios and thickness of the placenta. If the placenta is thicker than expected by the gestational age, this may be a sign of the onset hemolytic disease, that is, Rh-conflict during pregnancy. The circumference of the abdomen of the unborn baby is also important, the presence in it abdominal cavity fluids, enlargement of the liver and spleen. If they are enlarged, then these organs may begin to produce young red blood cells instead of destroyed ones. Another symptom is a decrease in blood flow velocity in cerebral artery baby. This indicator is measured with dopplerometry.

In order to prevent such serious complications, at the first visit of a woman to 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 pass an analysis to determine the Rh factor and blood type. If the Rh is positive, the woman will be taken under special control.

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

If an antibody titer is detected, until the 20th week of pregnancy, the analysis is repeated once a month, with its rapid increase - once every 2 weeks. Ultrasound from the 20th week in this case is 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 future baby, the woman is hospitalized in a specialized hospital. If the antibody titer rises rapidly, the woman will have a puncture of the amniotic fluid to determine the severity of the hemolytic disease in the baby. At the same time, it is decided whether a cordocentesis is needed - a fence cord blood to determine the level of hemoglobin in the child's blood. With small indicators, intrauterine blood transfusion is done. Then once a week will determine the titer of antibodies. Such measures alleviate the condition of the baby, but do not relieve the disease. You can get rid of it only after birth.

Rhesus 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 moment of the birth of the child closer. It is believed that caesarean section in such cases best way the birth of a baby, but it all depends on the condition of the child. By itself, Rhesus conflict is not absolute reading to the operation.

After birth, the child is treated for anemia and other manifestations of hemolytic disease. The level of bilirubin is also monitored daily.

Prevention of Rh conflict during pregnancy

If the blood is Rh-negative future mother antibodies are not detected, at the 28th-30th week of pregnancy she will be given an injection of anti-Rhesus immunoglobulin. If an Rh-positive baby is born, then during the first 48-72 hours after birth, the mother is also given an injection of anti-Rh immunoglobulin. This will help prevent conflict in the next pregnancy. The same injection is 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, with abdominal trauma during pregnancy and bleeding or placental or chorionic abruption.

blood type conflict

Rhesus conflict during pregnancy should not be confused with a blood type conflict. In this case serious problems for the health of the baby usually does not occur. 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. In contrast to the Rhesus conflict, the group conflict usually manifests itself after the first birth. After the second and subsequent births, it happens much less often.

Mother	Father	The child will inherit	Risk of group incompatibility
0 (I)	0 (I)	0 (I) 100% chance	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) 50/50 chance	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) 50/50 chance	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

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

Rh factor conflict

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

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

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

Spontaneous termination of pregnancy at different times;
premature birth;
stillbirth;
Jaundice in newborns requiring a 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

On the body of a Rh-negative pregnant woman, the Rh-conflict with her fetus is not reflected. 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, an examination of the fetus is necessary.

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

Puffiness and fluid accumulation 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 edema;
Thickening of the placenta and an increase in the diameter of the umbilical vein due to placental edema;
The fetus instead of the “fetal position” takes the “Buddha posture” - the limbs are laid aside from the tummy enlarged by the accumulated fluid.

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

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

Rhesus conflict during pregnancy

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

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

Previous pregnancies and births, if the fetus was Rh-positive;
Miscarriages, medical abortions, ectopic pregnancies and bleeding in Rh-positive pregnancies;
Getting Rh-positive blood through transfusions;
Passage of invasive prenatal tests - amniocentesis, chorionic biopsy.

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

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

How to reduce Negative consequences Rh conflict for the unborn child decides 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 therapeutic and preventive measures, individually or in combination, makes it possible to give birth healthy child with 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 abortions, previous births, miscarriages). The drug binds the formed antibodies and removes them from the body;
Prophylactic vaccination with anti-Rh immunoglobulin of a pregnant woman in the current pregnancy, starting from the 28th week, or within 72 hours after bleeding, amniocetosis;
Cordocentesis - intrauterine blood transfusion through the umbilical cord to the fetus;
Activation premature birth, according to the state of the fetus;
Replacement blood transfusion for a newborn;
Phototherapy of a newborn under special blue lamps.

pledge of birth healthy baby with Rh-positive blood in a Rh-negative mother is a timely appeal to women's consultation, it is better still at a stage of planning of pregnancy. A qualified physician will determine necessary measures prevention of the development of the Rhesus conflict.

The incompatibility of the mother with the fetus, which is based on defensive reaction female body: Rh positive baby blood cannot exist with Rh negative mother. This is a very serious phenomenon, since the Rh conflict leads to fetal fading, artificial termination of pregnancy and dead birth 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 at the top of the red blood cells. This element is present in the blood of 85% of the inhabitants of the planet, but 15% do not have such a lipoprotein, and therefore are Rh negative group. Specialists have developed a system for classifying the Rh factor depending on the blood group and its Rh, a positive Rh factor is designated Rh (+), and a negative one - Rh (-).

Rh conflict during pregnancy occurs exclusively in women with a negative Rh factor. A child can inherit Rh positive paternal blood, hence all subsequent problems follow. The mother's body perceives the child as a virus and directs all its forces to fight it. Rhesus conflict between mother and fetus is not observed when the patient has Rh (+), and the child and his father have Rh (-). The decisive role is played by 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 maternal immunity still does not produce athyrhesus bodies enough, but problems can arise on later dates pregnancy. At every next conception the child's immune system will increase the amount of antibodies in relation to the Rh factor of the fetus. It is these antibodies that penetrate the child's blood and provoke such a phenomenon as the Rhesus conflict.

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

What is Rh conflict during pregnancy?

The process of adhesion of Rh-positive and Rh-negative red blood cells is called agglutination. It is with this phenomenon that antibodies connected to the Rh protein - immunoglobulins - fight. These antibodies are of only two types: IgM and IgG.

The contact of maternal antibodies with the erythrocytes of the child 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 the fetus through the placenta. Therefore, the Rh conflict during the first pregnancy is enough a rare occurrence. But when the baby's positive molecules enter the woman's blood again, the active production of antibodies of the second type begins - IgG. Their size is much smaller, so they can easily seep through 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, the 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 during the second pregnancy either. Do not be afraid ahead of time and worry about the negative Rh factor, as it is not a contraindication for conceiving a child. It’s just that Rh-conflict pregnancy should proceed under the supervision of specialists, and future mother must be extremely careful in everything.

Causes of Rh conflict

The following factors can provoke this phenomenon:

The Rh-positive blood of the child enters the mother's Rh-negative blood at the time of the birth of the child, which activates the further production of antibodies in the female body. Antibodies formed once remain in the body for life.
Rh-incompatible blood of the patient and the fetus can connect during the pathological course of pregnancy: the development of a fertilized egg outside the uterus, surgical intervention, spontaneous abortion, bleeding, blood transfusion with a positive Rh. All of the above factors are possible cause the occurrence of serious complications during the subsequent bearing of the child.
The production of antibodies in the female body is affected by early prenatal tests: amniocentesis, chorionic biopsy. To obtain the test material, intrauterine intervention is necessary, which creates the possibility of getting the Rh-positive blood of the fetus into the mother's blood.

Specialists also distinguish a group of risk factors not associated with pregnancy and childbirth, which significantly increases the chance of a mother-child Rh conflict:

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

Symptoms of Rh conflict during pregnancy

Rh-conflict of mother and child does not have a clear severe symptoms. It is possible to detect the presence of hemolytic disease during the passage of an ultrasound. During the examination, the doctor will be able to identify the accumulation of fluid in the abdominal cavity, which provokes an uncharacteristic increase in 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 of the child. Specialists distinguish three types of the disease: edematous, icteric, anemic.

Development 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 developed anti-Rh bodies with Rh (-) in the mother's blood and on the level of development of the fetus. Serious complication is the formation of dropsy of the fetus, the development of edematous syndrome of the baby and pathological increase the weight of the fetus, which leads to its death.

Diagnosis of Rh-conflict

Diagnosis consists in examining the female body and identifying risk factors possible development hemolytic disease. Becoming registered, every pregnant woman and father of the unborn child in without fail take a blood test that determines its group and Rh factor. If a woman was found to have a negative Rh factor, and a positive one in her father, it is necessary to donate blood once a month for the study of antibodies and control of their development.

At the initial detection of antibodies, it is necessary to determine their class of manifestation. After the 20th week of pregnancy, the patient must be examined by a specialist who will determine the method and term of the upcoming birth.

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

Non-invasive:
- an ultrasound examination is carried out for the presence of pathologies in the fetus, the dimensions of its organs, the diameter of the umbilical vein, and the thickness of the placenta are studied. In the normal course of pregnancy, ultrasound is performed 3 times: at 18-20 weeks, 30-32 weeks and just before the birth of 34-36 weeks. If the child's condition is not normal or a blood transfusion was performed on the baby, then an ultrasound examination can be performed every day;
- dopplerometry; a method that evaluates the functionality of the heart muscle, indicators of blood supply large vessels and umbilical cord;
- cardiotocography; sent for examination of cardio-vascular system, which also helps to determine the lack of oxygen in the fetus in time.
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 present is studied. The method is very accurate, but, unfortunately, it carries great danger: an infection can get into the fetal bladder, intervention can lead to premature birth, bleeding. Amniocentesis is indicated for women who have had a previous birth hemolytic disease baby.
- cordocentesis: blood sampling involving the puncture of the umbilical cord. This method used in cases where it is necessary to make a blood transfusion to a child and as accurately as possible to determine the severity of hemolysis. 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 the umbilical cord puncture. Cordocentesis is prescribed for women who have had Rh incompatibility during previous pregnancies. If at ultrasound examination symptoms of hemolytic disease were detected, and the amount of antibodies produced exceeds the norm, it is also necessary to perform cordocentesis.

Complications after use invasive methods diagnosing Rhesus conflict between mother and fetus can be very serious, so everything possible must be done to avoid intrauterine intervention. A woman must be consulted and explained the risk that the fetus is susceptible to. 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 its agreement for the further application of the procedures.

Treatment of Rh conflict during pregnancy

Modern therapeutic techniques allow you to effectively and quickly eliminate the threat to life for the fetus, saving him life and supporting normal performance pregnancy. by the most effective method there remains a blood transfusion of the fetus, which is prescribed for the development of anemia in the child. 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 hemolytic disease in the newborn is also significantly reduced.

Women whose antibodies were found on early dates or past pregnancy was accompanied by Rh-conflict of the mother and fetus, belong to the group with increased risk complications. Until the 20th week, patients should regularly visit the women's office, and after that they are sent for inpatient treatment.

Also, treatment may be based on the purification of maternal blood. For this, procedures such as plasmapheresis or hemosorption are used. It is possible to weaken the patient's immunity with the help of desensitizing therapy and immunoglobulin treatment. However, statistics indicate the inefficiency 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 performed. Rh-conflict pregnancy usually ends in premature birth, since in the last stages anti-Rhesus bodies that enter the child are produced in more. The methods and terms at which delivery is carried out depend on the individuality of the female body and the severity of the fetal condition. The most sparing method is considered a caesarean section, which is why it is the most common way to give birth to a baby. If the patient has reached the 36th week 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 injected with anti-Rhesus immunoglobulin D. This is very effective drug, which has passed 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 time that there is an increase in the risk of developing a Rh conflict between mother and fetus. Reapplication the drug must be taken 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 takes 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 and the father of the child. If a man has a positive Rh factor, then the fetus can inherit his Rh factor, which can provoke a Rh conflict with the mother. In this case, the pregnant woman is regularly examined and the number of developed anti-Rhesus bodies is checked. If antibodies are not detected, then the child is not in danger. Immediately after birth, blood is taken from the baby for analysis and determination of the group and Rh factor of the blood. If the result indicates that the baby has Rh positive blood, then the mother is also injected with immunoglobulin D to prevent the possibility of an Rh conflict during future pregnancies.

Most experts are inclined to believe that it is also worth administering immunoglobulin after a blood transfusion of a positive Rh factor or platelet mass, exfoliation of the placenta, injury to the expectant mother, chorion biopsy.

The desired replenishment of 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 are mismatches in the Rh factors of the baby's parents, because in such a situation it can manifest itself, which can negatively affect the formation of the fetus or even cause the loss of the child.

When doctors still knew nothing about blood types and the existence of the Rh factor, sudden spontaneous abortion or premature birth, a stillborn baby or a newborn with severe pathologies were explained different reasons, A real ways to influence the situation simply did not exist.

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

Rh factor is a special type of protein, an antigen located on the surface of red blood cells- erythrocytes. 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 the blood of which the Rh factor is not detected, is considered Rh-negative.IN ordinary life it has almost no effect on normal life person.

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

This happens during blood transfusion and during childbearing, when the blood of a woman and fetus have various meanings. The presence of blood with a different meaning is perceived by human immunity as an invasion foreign bodies, so it attacks the cells of the "foreign" blood, producing antigens that destroy the "aliens". There is a so-called Rhesus conflict. 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, gestation ends safely with delivery. But the 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 blood from 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 to develop hemolytic disease. This condition also does not affect the development of pregnancy.

Carrying out diagnostic measures

Rh-conflict occurs if 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 connection between the blood of the mother and the fetus and the appearance, since this requires the penetration of maternal blood through the wall of the uterus and the 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 a sample of amniotic fluid and other invasive manipulations, when the blood of the mother and child can mix.

At the birth of a child or when performing caesarean section, manual separation placenta, artificial termination of pregnancy 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 the second pregnancy can occur with a very high probability.

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

. After the first pregnancy, a woman already knows what the Rhesus conflict threatens and is aware of the existing problem. If the child is from another man, it is necessary to perform an analysis of his blood to identify the Rh factor. If he is negative, like his wife, there is nothing to worry about, but a positive one can cause backfire. It is necessary to do analyzes as early as possible, since the sooner the problem is identified, the more likely it is to successfully cope 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 discover characteristics conflict: a double contour of the head, an enlarged abdomen, heart and edematous umbilical veins, a characteristic "Buddha posture".
Doppler. This study allows you to examine the state of the vessels of the fetus and placenta.
CTG (cardiotocography). The study examines the heart and vascular system fetus, revealing hypoxia - lack of oxygen in the blood.
Amniocentesis. This invasive technique is a test 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 to diagnose the most early stages hemolytic disease. Like amniocentesis, it can be a dangerous procedure, as it threatens to allow the mother's blood to enter the vessels of the placenta, and from there into the bloodstream of the body of the unborn child.

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 the manifestation of hemolytic disease of the newborn.

This disease can manifest itself 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 on time emergency assistance he might die. Anyway, internal organs children can be severely affected.

Hemolytic disease of the newborn manifests itself in three degrees:

icteric.
edematous.
Anemic.

The most dangerous option is the development of an edematous form of the disease. In this case, all the organs of the child suffer, and it is very difficult to treat it. The most common state of moderate severity - icteric form diseases. Main danger diseases - his sudden appearance and rapid development, if at this moment the parents are not around, they will be confused and will not be able to take action, or the problem will occur 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 measures to treat the consequences of the Rhesus conflict are so important.

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

When detecting opposite values of the blood of the mother and fetus, doctors usually carry out delivery ahead of time, since in this case, with each extra day of gestation, the risk of getting a large number antibodies from mother to fetus is constantly increasing. Far from always, incompatibility is manifested by a too pronounced, violent reaction, therefore it may not pose too high a threat to the newborn. In such a situation, even treatment is not always necessary.

After the birth of the baby, he is most often placed under a blue lamp. Phototherapy sessions contribute to the cure of hemolytic disease or prevent its development, stop its symptoms. Already sick children are treated in exactly the same way, plus they add the necessary drug treatment, blood transfusion and other methods aimed at saving the life of an infant.

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

Typically, this operation is performed when previous pregnancy the child suffered from 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 gave birth to her first child with an Rhesus conflict within the next 72 hours after birth.

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

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

Breastfeeding with Rh conflict

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

After childbirth, doctors most often advise to refrain from breastfeeding for some time in order to remove potentially dangerous antibodies from the mother's body. Other experts equally strongly 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 intact and there is no danger of blood entering the digestive tract child, breast-feeding can not harm the health of the baby.

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