If the father and mother have different Rh factors. How is the Rh factor inherited?

For married couples For those planning to have a child, doctors advise checking their blood groups and their compatibility in advance. This manipulation will eliminate the possible manifestation of incompatibility in the blood group of partners during pregnancy, because such a pathology immune system may lead to complications various kinds, both at conception and during pregnancy, childbirth and the postpartum period.

If the tests have not been completed, then the girl, when she comes to the doctor for a consultation with a gynecologist, will receive a referral for a diagnostic examination, which will include testing for partners during pregnancy. The fetus receives any of the four blood types, because during the development of the embryo four are formed, but the probability of getting the same as one of the parents is slightly higher than the others. In the case of the presence of single blood, there is a high probability of both parents.

It is absolutely certain that blood different groups doesn't have important role into the child. Let's consider the main thing about the Rh factor. What is Rh conflict in partners and its impact on the fetus. Ideally, both parents should have the same Rh factor, since with different indicators there is high probability the occurrence of problems that arise throughout pregnancy and even in the postpartum period.

If the parents found out in advance, it is recommended to undergo a special course of treatment that will help prevent various complications, for example, rejection of the embryo by the mother’s body.

If you do not take all possible measures to prevent Rh conflict, it is necessary to constantly monitor the dynamics of the condition of the fetus throughout all 39 weeks of pregnancy.

Modern medicine allows you to timely determine the presence of Rh conflict and can eliminate it through the introduction of a special serum - anti-Rhesus immunoglobulin at the 26th week of pregnancy.

Rh conflict between mother and fetus

If the mother is positive and the child is positive, then this situation does not pose a danger. This should under no circumstances cause parents to panic. It is much more dangerous if it is the other way around: the child has a positive Rh factor and the mother has a negative Rh factor. In this case, it will most likely occur. What is the danger?

When fetal blood cells enter the mother's blood, they will be mistakenly identified as a protein of foreign origin, which will be reflected in an immune-type response. In this case, it is necessary to constantly monitor the level of the mother’s Rh antibodies.

Before 28 weeks of pregnancy, it is necessary to take an Rh test monthly, and after 28 weeks - every 2 weeks.

It is also necessary to pay attention to the liver of the unborn child: if it enlarges, sometimes there is a need for intrauterine pregnancy, and sometimes it is even necessary to terminate the pregnancy.

Therefore, when planning to conceive a child, most parents should be concerned about the possibility of developing Rh conflict. Few people know about the danger posed by incompatibility in the blood type of partners during pregnancy.

We know that blood group I contains alpha and beta antibodies, but there are no antigens (A, B). Others contain antigens, and this is due to the fact that the first blood group, encountering these antigens, provokes a fight, which results in the destruction of red blood cells. This situation is called an immune conflict, or blood incompatible with each other, and in our case, incompatibility in the blood group of partners during pregnancy. Strictly speaking, these are the reasons for the incompatibility.

Table of compatibility and incompatibility of blood groups

Risk area

Let's figure out who is at risk? Risk groups include mothers and children who have different groups from each other (see table above).

• Mother I, III, and fetus II;
• Mother I, II, and fetus III;
• Mother I, II or III, fetus IV.

Women with the alpha-beta blood group who are carrying babies with antigens A or B are at greatest risk. This combination can lead to a condition that is manifested by a disease such as hemolytic jaundice. Particular attention should be paid to the following combinations:

• Mom I – dad II, III, IV;
• Mom II – dad III, IV;
• Mom III - dad II, IV.

In order to have additional opportunities to avoid this pathology, it is necessary to find out what influences the conflict and its development?

If the pregnancy period proceeds without any peculiarities, there is a high probability that there will be no conflict, for which it is worth saying thank you placental barrier, which eliminates as much as possible the possibility of mixing the blood of mother and fetus. If the blood does mix, there is a possibility of developing hemolytic jaundice of the newborn.

Photo of the occurrence of Rh conflict

Identifying and treating incompatibility

It is necessary to constantly keep in touch with your doctor. It is with a close connection between the doctor and the patient, if the patient asks a lot of questions, that he will be able to understand how to identify the incompatibility of the Rh factor, treatment methods and prevention of pathology.

Medical examination of pregnant women makes it possible to identify incompatibility of blood groups, which is supported by high antibody levels. The emergence of this conflict in a newborn child manifests itself the following symptoms: pallor and jaundice skin, hepatosplenomegaly.

In order to prevent complications and the occurrence of complications, doctors recommend taking a hemolysin test.

If hemolysins appear, the woman will be in the hospital department long time under the supervision of doctors. Hemolytic jaundice newborns should be treated to avoid various complications. The intensity of the conflict will be indicated by the symptoms of the disease.

To establish a diagnosis and verify the presence of Rh conflict, it is necessary to regularly take liver tests, and, if high performance- start therapy.

Therefore, young parents, in order to avoid emotional stress during pregnancy, are recommended to conduct all kinds of examinations in advance, and only then begin active actions.

Video: Blood type and Rh conflict

All cells of the human body have antigens, or “tags” in other words. Tags are special proteins on the surface of cells. There are usually not one or two such antigens, but many, up to 50. The Rh factor is the presence of these proteins on the outer membrane of red blood cells. If these proteins are present, then the person is Rh positive; if they are not there, Rh is negative. The ratio of Rhesus in the world is approximately as follows: 1-2 people out of ten are owners of Rh-negative blood.

Rhesus conflict as it is

If an Rh-negative mother carries an Rh-positive baby (and vice versa) from a correspondingly Rh-positive father, then she gradually develops a serious condition, which doctors call “Rh-conflict”. With it, the woman’s body begins to react to the embryo as a foreign body, hostile in nature. Antibodies to the baby's blood proteins begin to be produced in the mother's blood. Antibody production is essentially destruction foreign body. In 99% of cases it leads to miscarriage or death of the fetus inside the mother's body, but this happens under certain circumstances.

Why is this happening

Rh conflict triggers a process in the mother’s body called agglutination. This word literally means blood clotting: red blood cells stick together due to the influence of foreign proteins on them, and the blood coagulates like sour milk, leading to the woman’s death. To prevent this from happening, human body worked out defense mechanism- production of antibodies that destroy red blood cells of a fetus with the opposite rhesus. This process of protection is called sensitization.

What does this mean for mother and child?

If this is your first pregnancy, there will be no Rh conflict - attention! - if even microscopic particles of the child’s blood do not enter the mother’s bloodstream. The placenta is a kind of barrier between the blood of the fetus and the pregnant woman. She protects female body from the penetration of the child's red blood cells. But if children's red blood cells enter the mother's blood, the mechanism of sensitization, or antibody production, is immediately triggered.

When this might happen:

After usual first childbirth;
after an abortion or miscarriage;
as a result of the first ectopic pregnancy;
due to uterine bleeding in a pregnant woman;
as a result of sample collection amniotic fluid which is done during an analysis such as amniocentesis;
with a number of other examinations that are necessarily carried out in the first trimester to identify serious pathologies baby development.

Thus, any situation where the blood of the mother and fetus with different Rh factors are mixed triggers a Rh conflict. The result of such activity of the maternal body is miscarriage, miscarriage. Even if the first pregnancy went without problems, during the second there will definitely be a Rh conflict, which will lead to the death of the child. But there is no reason to despair. Modern medicine has developed a number of measures that prevent the loss of a baby and allow you to safely carry a second pregnancy to term.

What does this mean for a child?

Rhesus conflict is very difficult and dangerous condition, which is fraught with more than just miscarriage. Even if the second pregnancy was carried to term without appropriate treatment, sensitization will lead to severe developmental defects of the child:

Hemolytic disease with the development of subsequent anemia;
defeats internal organs(liver, heart, etc.);
brain damage with subsequent development of dementia and other abnormalities.

If a woman was not properly observed by a doctor during her second pregnancy and has a healthy first child, there is almost a 100% guarantee that her second baby will be born seriously ill (if she is born at all). For this reason, all pregnant women and women planning to conceive must have a blood test and, if there is a threat, be especially carefully observed by a doctor throughout the entire period of gestation.

When characteristic features Rhesus conflict, the baby may require a blood transfusion while still in the womb. To prevent problems in the future, the mother is given Rh immunoglobulin serum after the first birth (or abortion). This procedure must be repeated for the second, third and all other pregnancies, because the immunoglobulin is only valid for 12 weeks. With all the problems and difficulties listed above, it is possible to give birth with a difference in the parents’ Rhesus, but you should treat this process with special care, keeping in mind the existing threats.

Surely all people have heard about the Rh factor, but most likely, most of them do not really understand what it is. It does not affect human health in any way Everyday life, but during pregnancy, the incompatibility of the Rh factors of the father and mother sometimes provokes a Rh conflict. It is about Rh conflict during pregnancy with my husband that we will talk today on the website www.site.

The Rh factor is determined by the presence of a special protein on the surface of red blood cells (erythrocytes). It characterizes the immunological properties of blood. It was discovered relatively recently, in 1940. This was done by scientists Landsteiner and Wiener. In their research they dealt with monkeys and described rhesus macaques, which is where the universal term arose. The Rh factor is designated by the Latin symbols Rh+ or Rh-.

According to statistics, the majority (85%) of people on Earth have a positive Rh factor, i.e. this protein is present in their body. 15% of people do not have this protein and they have Rh negative. Rhesus affiliation is determined together with the blood group, but it does not depend on it in any way, it is a genetic sign of a person, his individual feature, as well as eye or hair color. It is inherited from one of the parents, remains unchanged throughout life and does not indicate any physiological disorder or disease.

Rh conflict can occur during blood transfusions if it is Rh incompatible, also during pregnancy, when the mother is Rh negative and the child is Rh positive.

With a combination of a “negative” mother and a “positive” child, the occurrence of Rh conflict is more likely than in the opposite case, as well as the consequences of such a combination may be more serious. This is known from many years of observations of pregnant women.

Why is it dangerous? different rhesus during pregnancy?

When positive red blood cells enter the blood of a person with a negative Rh factor, the body immediately reacts to them as a foreign object and begins to produce antibodies to neutralize the uninvited guests. These “protectors” enter the blood of the unborn child through the placenta and cause hemolytic disease, because they destroy his red blood cells, which carry oxygen. Due to lack of oxygen, the fetus develops pathological condition, oxygen starvation, the consequences of which are not difficult to predict.

But this does not mean that a woman with a negative Rh factor will certainly have a difficult pregnancy. Rhesus conflict is provoked by antibodies produced in the mother’s blood; everything depends on their quantity. In most cases, antibodies are either absent altogether, or their amount is minimal and not dangerous for the child.

What affects the production of antibodies in a mother with a negative Rh factor?

The greater the number of births and abortions a woman has, the higher the likelihood of Rh conflict. Everything is due to the fact that in this case, foreign red blood cells most likely have already entered the woman’s blood, i.e. the mechanism for producing antibodies has already been launched; her body already has experience in dealing with this kind of foreign bodies.

When the placenta is damaged and infections thin it, the penetration of red blood cells into the bloodstream also increases. The production of antibodies can also increase if the mother had a blood transfusion without taking into account the Rh factor, even if this procedure was a very long time ago. As a rule, the first pregnancy in women with a negative Rh factor is normal, because her body has never encountered “foreign” red blood cells and the protective mechanism, which is dangerous for the fetus, has not yet gained strength.

Determination of Rh factor

In order to avoid Rh conflict with your husband during pregnancy, expectant parents first need to take tests to determine this blood factor. When a woman has the same Rh as her husband, there will be no problems with compatibility. If future father“positive”, then the child will most likely genetically inherit positivity, as more strong sign. If the future father has a homozygous genotype, which is responsible for the Rh factor, then the child will 100% be born with Rh positive. If the future father has a heterozygous genotype responsible for the Rh factor, then the probability of having a child with a positive Rh factor is 50%.

When there is a risk of Rh conflict while carrying a baby, the expectant mother needs to regularly do a blood test for the presence of antibodies. This is usually especially important from the 35th week. From this gestation period this is done weekly.

If the test results do not show an increase in the level of antibodies, then the doctor may give an anti-Rhesus immunoglobulin vaccination as a preventive measure so that it blocks the baby’s red blood cells from entering the mother’s blood.

If the level of antibodies increases and reaches a critical state, the expectant mother will be referred to perinatal center so that she is under constant supervision of specialists. They will have to control:

* dynamics of increase in antibodies in the mother’s blood;

* baby’s reaction – is the liver enlarged, is the placenta changing, is fluid appearing in the pericardium and abdominal cavity;

* state of fetal fluid and cord blood.

With progressive Rh conflict, doctors do C-section so that the mother's protective antibodies do not harm the child. On short term pregnancy when artificial birth are not yet possible, we have to resort to intrauterine transfusion blood.

If there are no complications during pregnancy and no antibodies are produced, then after birth, within about 2 days, the mother should receive an injection of anti-Rhesus immunoglobulin. This will reduce the risk of Rh conflict when next pregnancy.

Such vaccination for women with negative Rh is also necessary for miscarriages, abortions, ectopic pregnancies and blood transfusions.

Successful advances in clinical immunology Lately show that negative Rh is not a death sentence at all, it only forces you to approach the bearing and birth of a child more responsibly.

Is it a threat to the life of the unborn child if the pregnant mother and the future father have Rh-negative blood? Is Rh conflict possible during pregnancy if the future parents have different Rh factors? What is the compatibility and how is the Rh factor inherited?

Rh factor is a special protein found in red blood cells. And we have a lot of different proteins in our blood, about 70. 85% of people have the Rh factor, 15% do not. And if the Rh factor is expectant mother and the future father is negative, there is nothing to fear for the child!

Rhesus conflict during pregnancy.

When a pregnant woman has Rh negative blood and her husband has Rh positive blood, doctors fear an Rh conflict between mother and fetus. The possibility of Rh conflict is about 75%. However, it occurs only when the fetus has the same blood as the father, that is, Rh-positive. With proper prevention, you can reduce the likelihood of Rh conflict.
During pregnancy, mother and fetus are one, and, despite the fact that their blood does not mix, many metabolic products and individual cells from the fetus go to the mother, and vice versa. This exchange occurs through the structures of the placenta, through that part of it called the placental barrier.
And now fetal red blood cells containing the Rh factor begin to enter the mother’s bloodstream. But there is no such factor in her blood; this protein is foreign to her body. And here the biological defense mechanism turns on: after all, in any case, when a foreign substance enters the body, it begins to produce weapons against it - so-called antibodies.
The further pregnancy develops, the more red blood cells containing the Rh factor accumulate in a woman’s blood and, accordingly, the number of antibodies hostile to them increases.
In the same way, that is, through the placenta, antibodies penetrate into the blood of the fetus. But they are aimed at destroying Rh-positive red blood cells, and under their influence, the fetal red blood cells begin to disintegrate and die. Toxic breakdown products accumulate in the blood, in particular bilirubin, which has a harmful effect on the entire body and especially on the brain.
It is because of bilirubin that the skin of the fetus acquires yellow color, according to the intensity of which doctors even before necessary research may suggest a hemolytic disease in a newborn (hemolysis - destruction, dissolution). In such cases, the child will be saved by an emergency blood transfusion.

How is the Rh status of fetal blood formed?

Why can't parents with Rh-negative blood have a child who has Rh-positive blood, but if the father and mother have Rh-positive blood, their child can have Rh-negative blood? What is this - an accident, a paradox? No, strict laws of genetics.
There are dominant and recessive genes, and in the presence of dominant ones, recessive ones do not manifest themselves. To make it clearer, let's call the Rh-positive gene Rh, and Rh negative rh.
It is known that each characteristic, be it blood type, eye color or the shape of the ear, is determined by at least two genes: one of them is contained in the chromosome received from the father, the other - in the chromosome received from the mother. Consequently, both father and mother always participate in the construction of pairs of genes that determine each trait, including the Rh factor. Even if a child has “paternal” blood, there are still maternal genes among the genes that determine its properties. And, of course, vice versa.
The Rh (positive) gene dominates over the rh (negative) gene, preventing it from manifesting itself. And, therefore, with Rh-negative blood there can be only one genotype - rhrh (if a “positive” gene was inherited from one of the parents, the “negative” one would be suppressed and the blood would be Rh-positive).
People with Rh-positive blood can have two combinations of genes - either RhRh, that is, identical positive ones received from both parents, or positive and negative - Rhrh (the negative is suppressed by the positive, it could not manifest itself, but it exists).

If a man and a woman with Rh-negative blood marry, the blood of the child will be the same, since neither the father nor the mother has a single “positive” gene.

And in people with Rh-positive blood, there may be an undetected “Rh-negative” gene. And if each parent passes on one such gene to the child, the child’s blood will be Rh negative. True, according to the laws of genetics, the likelihood of such an option is low.

If one of the parents has Rh-positive blood Rh, and the other has Rh-negative Rh. In this case, the child may be born with negative or positive Rh blood. But there is a possibility of Rh conflict. But this is not a reason to refuse pregnancy.
It is believed that 10-13% of marriages are between people with different Rh blood factors. However, the frequency hemolytic disease Newborns in relation to all marriages are only 0.3-0.7%. The fact is that the response to an Rh-positive factor does not occur in all women with Rh-negative blood. The production of antibodies is facilitated by previous pregnancies and abortions (if the fetus in those cases was Rh-positive) or transfusion of Rh-positive blood.
But under all conditions, the development of hemolytic disease in a child can be prevented. The expectant mother just needs to contact the antenatal clinic, where they will monitor whether antibodies appear in her blood, and if they are found, they will take the necessary preventive measures.

While expecting a child, a woman goes through many mandatory studies. Among them is a blood test for Rh factor. If you have a positive Rh factor, then you don’t have to read the rest of the article; the Rh factor will not affect you. If you know (and it happens that you only found out for the first time during pregnancy) that you have a negative Rh factor, then I suggest reading the material below - this knowledge will not be superfluous :)

First, a little theory. Our blood contains red blood cells - erythrocytes. On their surface, as well as on all other cells of our body, there are receptors. They are needed so that cells can “recognize each other” and, so to speak, “communicate”, that is, carry out intercellular interactions. It is with the help of receptors that our body distinguishes between “our own” and “foreign” cells, since they are carriers of individual information. There are more than a hundred receptors on one red blood cell alone. One of the main receptors on the outer membrane of red blood cells is the ABO protein system - the well-known blood group system. And the main receptors of the inner membrane are the blood protein Rh factor (this protein was first discovered in rhesus monkeys, which is why it is called that).

All people, depending on the presence or absence of this protein, are divided into Rh-negative and Rh-positive. About 85% of people have this same Rh factor and are therefore Rh positive. The remaining 15% who do not have it are Rh negative.

IN ordinary life Neither the presence nor absence of the Rh factor plays any special role. They become important only during blood transfusions and during pregnancy.If the mother and child have different Rh factors, then a Rh conflict may develop, when the mother’s body “considers” the baby’s blood a foreign substance and begins to produce antibodies, attacking the child’s blood cells.

But this does not always happen, but only with a certain combination of Rh factors of the mother and baby. Since the Rh factor is inherited from mom and dad, the child may have various options his inheritance. For example, Rh-positive parents can have both Rh-negative and Rh-positive children. Children with Rh negative parents will always have a negative Rh factor. And the parents with different Rh factor

(mom is positive, dad is negative or vice versa), there are also different options.

Let's consider all possible combinations of Rh factors.

Mother's Rh factor is positive

Let’s say right away that if the mother’s Rh factor is positive, then, regardless of what Rh factor her husband (the child’s father) and the baby himself have, no Rh conflict arises. For example: Rh positive mom + Rh positive dad = Rh-.

positive child The fact is that if the mother and the child have the same Rh factor, a conflict will not arise and pregnancy will pass

without complications.

If the mother and child have different Rhesus, the conflict does not develop, since the blood of a Rh-negative child does not contain the protein of the Rh system: there is simply no reason for the conflict to develop.

It turns out that a woman with a positive Rh factor does not require any additional research or treatment during pregnancy and childbirth.

Mother's Rh factor is negative Here, too, various options are possible. If the mother is Rh negative, then the Rh factor of the child's father and the Rh factor of the baby itself are of great importance. Very good option , when the mother’s negative Rh factor coincides with the negative Rh factor of the child’s father or the baby himself. For example: Rh-negative mother + Rh-negative father = Rh-negative child; or Rh-negative mother + Rh-positive father = Rh-negative child.

Mother and child have the same Rh factor, and there is no conflict.

If the pregnancy proceeds without complications, then the blood of the mother and child does not mix - there is a certain filter barrier between the woman and the fetus (feto-placental barrier - FPB). But this barrier is broken during childbirth (with severe toxicosis and diseases in which the FPB is damaged, as well as during termination of pregnancy, ectopic pregnancy) and a certain portion of the child’s blood enters the mother’s bloodstream. The red blood cells of a Rh-positive child are perceived by the body of a Rh-negative mother as foreign “agents”; the mother’s body begins to actively defend against them and produces special antibodies, the task of which is to destroy foreign blood cells, that is, in this case baby's red blood cells. That is, it turns out that the first pregnancy is Rhesus negative woman from a Rh-positive man it occurs without complications; simply, after childbirth, antibodies to the positive Rh factor remain in the mother’s blood for life. What will happen next?

But during the next pregnancy, if unborn child will again have a positive Rh factor, Rh conflict develops. The mother's antibodies penetrate the baby's bloodstream and destroy his red blood cells. This process may begin in utero. Will appear in the child's blood a large number of bilirubin pigment, which is a breakdown product of red blood cells and is toxic in high concentrations. The fetal body will defend itself: the spleen and liver will begin to work harder, and they will increase significantly in size. If a child has few red blood cells left, he will develop anemia - low content in the blood of erythrocytes and hemoglobin. Others will happen pathological processes. This disease is called hemolytic disease of the fetus. If the process of destruction of the child’s red blood cells begins or continues after birth, then this will be hemolytic disease of the newborn. There are several degrees of severity of this disease, and in severe cases, treatment involves a replacement blood transfusion to the child. And sometimes it is even performed in utero. Therefore, it is so important to determine the mother’s Rh factor during the first pregnancy and prescribe rhesus conflict prevention in a timely manner. Severe hemolytic disease is not easy to treat, and even in the case of a favorable outcome, consequences for the baby’s health are possible.

In order to prevent the development of Rh conflict in the future, a woman with Rh-negative blood should be given anti-Rh gammaglobulin within the next 72 hours after the first birth (the sooner the better).

This substance blocks foreign “positive” red blood cells and removes them from the body.

In Russia, the Ministry of Health has been preventing Rhesus conflicts for many years and recommends observing the following rules. 1.If a woman with Rh-negative blood had a termination of pregnancy before 12 weeks or ectopic pregnancy

, then it is impossible to find out the child’s Rh factor. In such a situation, she needs to be given anti-Rhesus gammaglobulin within the next 72 hours after surgery.

2. During pregnancy, women with a negative Rh factor need to regularly take blood tests and monitor the presence or absence of antibodies. If they are absent, 1 dose of anti-Rh-gammaglobulin is administered until 28-32 weeks of pregnancy, after which a repeat test is not required.

3. In children of all mothers with Rh-negative blood, the Rh factor must be determined within 2 hours after birth. If the child's Rh factor is positive, the mother must be given anti-Rh gammaglobulin within 72 hours. 4. Also, the administration of anti-Rh gammaglobulin is indicated for the prevention of Rh conflict, if invasive methods

studies (amniocentesis, cordocentesis) and in case of unfavorable pregnancy (bleeding due to placental abruption, etc.).

5. If a woman was not given anti-Rh gamma globulin after the first pregnancy and antibodies appeared in the blood, then there is no point in administering this drug during subsequent pregnancies, since the antibodies have already been developed. But strict medical control is still necessary.

To help you, we have compiled a reminder for the expectant mother:

1. Find out your Rh factor and the Rh factor of the child’s father.

2. If you have a negative Rh factor, then after the first and each subsequent pregnancy, ask to establish the child’s blood type and, if necessary, administer anti-Rh gammaglobulin to you within the first 72 hours.

3.If you have a negative Rh factor, regularly donate blood to check for antibodies.

4.If the expectant mother has a negative Rh factor, then she and her baby need a thorough ultrasound examination (especially pay attention to the placenta, liver and tummy of the baby). 5.Choose by birth or medical clinic

6. Immediately before giving birth, find out if there is anti-Rhesus gammaglobulin in the maternity hospital.