Mother's blood is Rh negative in first pregnancy. A negative Rh factor during pregnancy is not a death sentence

However, in case of pregnancy, an inappropriate combination of Rhesus parents can lead to the so-called Rhesus conflict.

Causes

The Rh factor is an antigen (protein) that is found on the surface of red blood cells - erythrocytes. It may be present (Rh positive) or absent (Rh negative). According to medical statistics, about 85% of people are Rh positive, the remaining 15% are Rh negative.

Rh conflict occurs either when transfusion of Rh-incompatible blood occurs, or during pregnancy of a woman with Rh negative, if the blood of the fetus is Rh positive.

What's happening?

When fetal red blood cells carrying proteins of the Rh system enter the blood of a mother with Rh negative, they are perceived by her immune system as foreign. The body begins to produce antibodies to destroy the baby's red blood cells. At the same time, it appears in his blood a large number of a substance called bilirubin, which can damage his brain. As the fetus's red blood cells are continuously destroyed, its liver and spleen try to speed up the production of new red blood cells, thereby increasing in size. In the end, they also cannot cope with replenishing the loss of red blood cells. Severe oxygen starvation sets in, and a new round of serious violations develops. In the most severe cases, this can lead to fetal death.

Who is at risk from Rh conflict?

Since the presence of the Rh factor is inherited, the threat of Rh conflict exists only if expectant mother is Rh negative (Rh-), and the father is Rh positive (Rh+). In this situation, in 75% of cases, the mother and child will be Rh incompatible.

But if a woman has a negative Rh factor and a man has a positive one, this is not a reason to refuse to start a family.

The first pregnancy of such a couple will most likely be normal. If a woman has not previously encountered Rh-positive blood, then she has no antibodies, and therefore no risk of Rh conflict with the fetus. During the first pregnancy, not so many antibodies are produced (this is the “first meeting”, after all). If the number of fetal red blood cells that entered the mother’s blood was significant, “memory cells” remain in the woman’s body, which, when next pregnancies organize the rapid production of antibodies against the Rh factor.

With an Rh-incompatible pregnancy, a lot depends on how it ended. After a miscarriage, Rh sensitization (production of antibodies) occurs in 3-4% of cases, after medical abortion- at 5-6, after ectopic pregnancy- in approximately 1% of cases, and after normal birth- at 10-15. The risk of sensitization increases after caesarean section or if there were placental abruptions. That is, it all depends on how many fetal red blood cells penetrate into the mother’s bloodstream.

Prevention

IN antenatal clinic A pregnant woman must be checked for the Rh factor. If it is negative, it is necessary to determine the father's Rh status. If there is a risk of Rh conflict (the father has a positive Rh factor), the woman’s blood is repeatedly tested for the presence of antibodies to fetal red blood cells and their number. Until the 32nd week of pregnancy, this analysis is carried out once a month, from the 32nd to 35th - twice a month, and then weekly until delivery.

Based on the level of antibodies in the blood of the expectant mother, the doctor can determine the possible onset of a Rh conflict and draw conclusions about the expected Rh factor in the child.

In addition, immediately after birth, the baby's Rh factor is determined. If it is positive, then no later than 72 hours after birth, the mother is administered anti-Rhesus serum ( anti-Rhesus immunoglobulin), which will prevent the development of Rh conflict during the next pregnancy.

The same prophylaxis with anti-Rhesus serum should be carried out by Rh-negative women within 72 hours after an ectopic pregnancy, abortion, miscarriage, transfusion of Rh-positive blood, platelet transfusion, placental abruption, trauma in a pregnant woman, as well as amniocentesis and chorionic villus biopsy (manipulation of fetuses). shells).

Treatment

If a pregnant woman has antibodies and their number increases, this indicates the beginning of a Rh conflict. In this case, treatment in a specialized perinatal center, where both the woman and the child will be under constant supervision.

It is important for a pregnant woman to know everything that concerns her state of health and her unborn baby. The topic of negative Rh factor causes fear not only among expectant mother, and also for those who are just planning to become parents. And all because there is a theory according to which negative Rh is akin to a sentence to infertility. Is this so? Let’s figure it out by gradually studying everything in order. Let's start with the main thing - the definition of the concept itself - the Rh factor.

Determined by performing a blood test. It is a protein in the blood that is found directly on the surface of blood cells. Women who have been diagnosed as having a negative Rh factor do not have this protein in their blood. However, there is no need to be afraid. According to statistics, about 20% of women worldwide to the globe have the same Rh factor, and many of them are quite happy mothers. Doctors claim that a negative Rh factor is simply individual trait a person, and not a pathology, and certainly not a diagnosis of infertility.

Why do many expectant mothers react so sharply to the topic of negative Rh factor? The fact is that Rh conflict does occur, but only in individual cases, which we will talk about in more detail.

Negative Rh factor, or Rh conflict poses a danger to a woman in labor only if her Rh factor does not coincide with the Rh factor of the unborn child. Those. The mother was determined to be Rh negative, and the fetus was found to be Rh positive. It is important to know that this phenomenon in medicine is very rare, although no less significant. But there is no need to worry in advance. After all, if the future parents have the same Rh negative Rh factor, there is no reason to worry, because the baby will probably also inherit the Rh factor of the parents. Therefore, at the first visit to the gynecologist, it is necessary to have both parents take a blood test and determine their blood type (if they have not done this before). Experienced gynecologists recommend this procedure take place in advance, when pregnancy is just being planned. This way we can avoid unnecessary worry, and in case of a problem with Rh factors between partners, we can consult with experienced specialists.

Next, let's figure out why Rhesus conflict still occurs between the expectant mother and the gestating fetus. It is known that our body is capable of fighting foreign bodies. So, during a flu virus or other infectious disease our body fights viruses, thereby ensuring our recovery. The same thing happens when the mother's Rh factor does not match the child's Rh factor. There is a constant conflict, the body fights with antibodies, which poses a threat to the development of the unborn child. It is in this case that the pregnancy takes place under the strict supervision of a doctor in order to minimize the threat of death of the child. Thanks to modern medicine, there are many ways that can quite successfully cope with the problem of Rh conflict between mother and child. An important factor is that with such a problem, according to general well-being, a pregnant woman is no different from other expectant mothers. It’s just that such women will have to visit the doctor much more often and take blood tests. But, you see, for the sake of the future baby, we will not endure such things. In some cases, Rhesus incompatibility between mother and child, doctors are forced to perform early births, as well as blood transfusions of the born baby. All these actions are quite successful in most cases, so there is no reason for fear or worry.

Measures to prevent a Rhesus conflict situation are also not excluded.

It is important to consider that, having given birth to your first child without special problems, it is not a fact that a subsequent pregnancy will not bring Rh conflict. In order to prevent this discrepancy, the expectant mother is given a drug called anti-Rh immunoglobulin. This drug allows you to bind aggressive substances and remove them from the body. Therefore, if you have a negative Rh factor, your partner has a positive one, and you have decided to have a second child, it would be advisable to introduce such a vaccine. Also, a vaccine with antibodies is administered both during pregnancy and immediately after childbirth.

Treatment of Rhesus conflict is a very common phenomenon in medical practice. And please note, it is very successful. Therefore, in the case when your tests have determined an Rh conflict, you should not panic and worry in advance. If you are a responsible and vigilant mother, then with the help of doctors and your consciousness you will soon join the ranks of another happy mom. What I wish for you with all my heart!

Especially for- Ira Romaniy

Now, of course, this does not happen - the 21st century is just around the corner - but the problem of Rh negativity in pregnant women remains.

What is the Rh factor?

Human blood is examined in laboratory conditions and is constantly being studied. At the same time, more and more new systems are appearing for “counting and reading” the information carried by any liquid, and blood, being a biological fluid, even more so.

There is an ABO system. Within this system, one of the most important antigens is released - antigen D. It is he who determines the Rh of a person’s blood.

If D is detected on the surface of red blood cells, then the Rhesus of the person whose blood was taken for analysis is positive. If there is no D antigen in the blood, then we can say with confidence that the Rh factor is negative.

It is on the basis of the determination of this antigen that the laboratory research by determining the human Rh factor. Medicine has come a long way, so they are done very quickly and are not complicated.

By the way, Every person needs to know both their blood type and Rh factor. This may be needed in emergency situations, during blood transfusion, and even more so for pregnant women.

What is Rh conflict?

When the mother is Rh negative and the father is Rh positive, the probability that their child will also be Rh positive is more than 60%.

A “negative” mother, carrying a “positive” child, exchanges with him during her life and pregnancy. nutrients through blood. And this is where the mother’s body can “sense something is wrong.”

Clinically, this can be determined in such a way that antibodies will appear in her blood, and their number may begin to increase rapidly. The body produces these antibodies to fight the D antigen present in the blood of a “positive” child.

Of course, no mother wishes harm to her child, but that’s how it works human body: having noticed that “something is not going according to the scheme”, or rather “the schemes do not match”, he begins to destroy what, in his opinion, is wrong. IN in this case this is blood little man. Rh conflict arises.

No matter how scary this name may sound, the Rh conflict can be smoothed out by infusing the child with “negative” blood, and a disease such as hematuria may not occur. It is quite a rare occurrence, and we will talk about it a little later.

Situations leading to Rh conflict

• “negative” woman + “positive” man;
• second and subsequent pregnancies of a woman with a negative Rh factor;
• the entry of the baby’s blood into the mother’s body during the first pregnancy;
• blood transfusion performed by the mother before pregnancy and without taking into account the Rh factor;
• pathologies during pregnancy: placental abruption and intrauterine bleeding requiring hospitalization;
• at the mother's.

If the child’s father is also “negative”, then, most likely, the child will again take after his father, and the pregnancy will go smoothly.

But even if the mother is “negative”, the father is “positive”, and the child is “positive”, there is no need to become depressed! Modern medicine is quite capable of providing you with the opportunity to carry and give birth healthy baby, no different from others.

Blood will need to be donated, perhaps, every week. However, all pregnant women are more later I donate blood every week, this is only at the very beginning - once every two months, and then once a month.

Features of pregnancy with negative Rhesus

Negative Rh factor is not a pathology, and the pregnancy of such a woman is in no way something unnatural.

Of course, you need to know your Rh (and the child’s Rh) and be prepared for complications, but in many cases the pregnancy of a “negative woman” is completely normal. Especially if the child’s father is also “negative”. However, even if this is not the case, you still shouldn’t worry ahead of time.

During the first pregnancy

During the first pregnancy the risk of its abnormal course is especially low, because the pregnant woman’s body has not yet developed antibodies to the baby’s antigens, and with maintenance therapy in a hospital setting, pregnancy can proceed more or less smoothly.

There is a small risk of the baby developing anemia(lack of blood), but by transfusion this problem is eliminated. The woman should be under constant supervision of an obstetrician-gynecologist, and her blood should be tested weekly, or even more often, to monitor the appearance of antibodies in the blood.

Modern medicine makes it possible to artificially reduce their number so that the child can develop unhindered in the womb and complete the pregnancy.

During childbirth there will be a peak in the formation of antibodies by the woman’s body to the blood of an Rh-positive fetus as a result of blood loss, and it makes sense to introduce a drug that will suppress the development of such antibodies in the future.

In many ways, it makes sense to do this if a woman is again planning a pregnancy with an Rh-positive man. This drug immunoglobulin, will help significantly reduce in the future " side effects» Rh-negative pregnancy.

During the second and subsequent pregnancies

If the woman has not had an injection of Rh immunoglobulin, then the risks increase with each subsequent pregnancy. This is where more serious problems begin: we are no longer talking about mild anemia and problems that can be easily solved by blood transfusions.

The child may develop pathology characteristic of pregnant mothers with negative Rhesus - hemolytic disease. If it is suspected, a pregnant woman is immediately hospitalized: it may be necessary to artificially maintain the life of the child in the womb. We will have to reduce their biological metabolism as much as possible, as if “protecting” the child from the antibodies of the mother’s body.

If the fetal red blood cells continue to be severely destroyed, bilirubin increases, and jaundice begins. The brain may gradually begin to deteriorate, in general, even if doctors manage to take this process under control, the chances of giving birth to a healthy child drop sharply.

That's why immunoglobulin vaccine has more value , if you are planning a subsequent pregnancy with a “positive” or “negative” man.

In addition, there are often cases when the second or third pregnancy of a “negative” woman has to be artificially terminated, because further bearing of the child becomes impractical and inhumane - neither for the parents nor for the baby.

A after an abortion There can be no question of a subsequent pregnancy for a woman with negative Rhesus.

The effect of negative Rh on the baby's health

Childbirth may occur prematurely due to stress and constant medical interventions. This in itself is not dangerous. In general, a child may be born completely normal, but his blood will be immediately taken for analysis.

In the first years of life, the baby may suffer from increased bilirubin in blood, which means that serious physical activity will be contraindicated for him.

The fact is that such a diagnosis implies high blood pressure on the brain and stress on the liver. The child will have to be protected from hepatitis throughout his life.

However, modern drugs are able to maintain liver function at the proper level for many years, and over time, due to the reserves of the young body, the child’s condition can improve to almost normal.

Hematogen will be shown to him as a treat to increase the level of hemoglobin in the blood. Otherwise, in adolescence Depression and apathy may begin, aggravated by hypotension - low blood pressure.

Such a child needs sports reasonable quantities: It is very important for him to be in good shape, then all his organs will be in good shape, and bilirubin will gradually normalize.

In short, don't be afraid or worry: it's practically healthy child , who will not be hindered one bit from achieving success in life by the fact that his mother had a negative Rh blood factor!

The main thing is to monitor his health and avoid overload. However, as you can see, such advice is relevant for almost all babies born in our century. So let's repeat it again: a child from a “negative” mother is normal.

Features of pregnancy management in women with negative Rhesus

It is advisable to immediately go into storage so that doctors are nearby as soon as their help is needed.

Rh negative blood should always be ready for transfusion in case the mother's antibodies begin to multiply too quickly and pose a threat to the fetus.

In principle, it is possible that the pregnancy will proceed completely calmly. In this case, the “on hand” will be weak the immune system a mother who will not have time to detect something “foreign” in her body during the period of gestation.

True, in this case, the expectant mother needs to be provided comfortable conditions stationary residence and exclude any possibility of contracting colds. This is especially worth paying attention to during heating shutdowns or hot water: You have to take good care.

Maternal blood test for antibodies is done at least once a week, drugs aimed at combating them are used only in extreme cases, but still it is better not to lead to the need for transfusion.

Prevention and treatment of Rh conflict

On how effectively they will be carried out preventive actions by a qualified doctor, it depends on whether treatment for Rh-conflict is needed at all, or whether it will be possible to get by with light supportive procedures.

However, the doctor’s arsenal for prevention is not so large: The most important thing is to catch the moment in time when the mother’s body begins to react too violently to the fetus. In a blood test for antibodies, all this is clearly visible. The ideal situation would be when there are no antibodies yet and the pregnancy is proceeding calmly.

As soon as antibodies appear in the mother's blood, the doctor must continuously monitor the child's condition. If he doesn't have enough blood, it may start oxygen starvation and anemia, and this is quite dangerous. To avoid this, blood with a negative Rh factor, like the mother's, is administered to the child through the umbilical cord, constantly monitoring his condition on monitors.

Sometimes an immunoglobulin injection may be necessary, suppressing the production of antibodies by the mother's body that destroy the red blood cells of the fetus. But this is only if the risk is justified, and maintaining the viability of the fetus in other ways becomes increasingly difficult.

After birth, the baby will most likely not require any treatment. At most, you will have to “clean” the blood a little and normalize all vital indicators.

Text: Evdokia Sakharova

To the expectant mother, in exchange card which is marked “Rh negative”, on recent months Pregnancy requires visiting doctors more often than usual. We asked an expert why doctors prefer to play it safe.

Doctor of Medical Sciences, Professor, says what the mother’s Rh negative poses to the expectant mother and her child. chief physician Moscow Health Committee Mark Arkadyevich Kurtser.

After giving birth, Rh-negative mothers need to be tested for antibodies.

The cause of Rh conflict is a protein located on the surface of red blood cells (Rh factor). About 85% of people have it - such people are Rh positive. The remaining 15% who do not have it are Rh negative. The presence or absence of the Rh factor does not affect human health in any way. This characteristic becomes of great importance only in one single case - when we're talking about about pregnancy. If the Rh factor of the future parents matches, then there will be no complications. But when a child is conceived by an Rh-negative mother and an Rh-positive father, he may inherit the father's Rh factor. Then there is a possibility of a Rh conflict.

The mechanism of Rh conflict

During pregnancy, the Rh factor from the red blood cells of the Rh-positive fetus enters the blood of the Rh-negative mother. It is perceived as a foreign substance - and the mother’s body gives the signal “Attention, we are under attack!” to the production of antibodies to the Rh factor, as a result, the child’s red blood cells disintegrate. Their breakdown leads to damage to the liver, kidneys, brain of the fetus, and the development of hemolytic disease of the fetus and newborn.

If this is your first pregnancy

As a rule, the difference in the Rh factors of the expectant mother and child during the first pregnancy during its normal course is not significant. Until the child's red blood cells enter the Rh negative Mom's blood, everything is fine. The natural barrier is usually the placenta, which reliably protects blood vessels women from such penetration.

If pregnancy is second

Antibodies are typically used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses. U Rh negative women Antibodies begin to be produced during the first birth, abortions and miscarriages. This process is called sensitization, and its intensity increases when even a small amount of the baby's blood enters the mother's bloodstream. During the first birth, antibodies do not have time to harm the baby.

Carefully!

In subsequent pregnancies, antibodies can pass through the placenta into the blood of the fetus and the baby can become seriously ill.

Almost all women know that abortion is dangerous. IN medical institution, where they are produced, may not test a woman’s blood for the presence of the Rh factor. It is possible that it will turn out to be negative. And if a woman with Rh-negative blood wants to get pregnant again to give birth to a child, she can expect big problems.

Dangers for the baby

If the number of antibodies in the mother's blood is small, they cause a mild form of anemia in the baby. When their number increases, the fetal body does not have time to produce new red blood cells. Then the child’s anemia occurs in a more serious form. Hemolytic disease of the fetus may occur, in which the functioning of the liver and spleen is disrupted and the organs themselves increase in size. As more severe manifestations of the disease, swelling of the tissues and brain can occur. Will a child get sick with Rh positive blood depends not only on the quantitative composition of antibodies in the Rh-negative mother, but also on their quality. Not all of them are able to penetrate the placenta and cause harm to the fetus. Then the child is born healthy or with mild form

diseases. Greetings, my dear readers! My sister dreams of having a second child. Moreover, she has a negative Rh factor. Naturally, she is very afraid, because on the Internet you can find horror stories

from people who have encountered this problem. Can a second child with a negative Rh factor really be born sick?

Where it all started

If there is a special protein on their membrane - an antigen, then such people are positive. This is about 85% of the world's population. The rest, which do not have such a protein, are negative. It got its name thanks to experimental rhesus monkeys.

IN medical science Rh negative factor is considered a genetic trait that does not affect human health. However, it becomes a cause of concern for many mothers who plan to give birth to more than one heir.

Blood conflict

Mommy's pregnancy will proceed without problems if both parents have a negative Rh factor or if both parents have a positive Rh factor. And vice versa, when the mother has a Rh factor with a minus sign, and the father with a plus sign, incompatibility occurs, the risks of miscarriage and fetal pathology increase.

The reason is that at the end of the first trimester of pregnancy, at 7-8 weeks, the embryo begins to produce red blood cells, which can enter the mother’s bloodstream. There are two possible situations here:

• The baby has the same small proteins, his Rh with a plus sign;
• They are simply not there, Rh is with a minus sign, there is nothing to react to.

If red blood cells from a “positive” child enter the body of a “negative” mother, the mother’s immune system begins to defend itself and produce antibodies (“memory cells”). This situation is a big one. Antibodies begin to kill the baby’s red blood cells, there are fewer and fewer of them, and fetal hypoxia occurs. There is an accumulation of fluid in the tissues and organs of the baby.

In addition, the caustic substance bilirubin accumulates in the body of the small body. It slows down the baby's development process. All these signs are called hemolytic disease newborns (GBN).

Rhesus conflict may not necessarily develop when different rhesus in mother and child. After all, it is quite tightly protected by the placenta. If doctors carefully monitored the course of pregnancy, took compensatory measures in a timely manner and prevented incest during childbirth, such an unfavorable situation does not happen.

Many expectant mothers are concerned about the question: does the risk of Rh factor conflict increase during a second pregnancy? Yes, if the first baby had positive blood, then with the second, the risk of Rh conflict increases greatly (in my case there were two babies with positive). This happens because the mother’s body already “remembers” the past struggle.

Upon repeated exposure, the immune system begins to produce antibodies in an enhanced mode and they easily penetrate the placenta. Their formation can be provoked by a blood transfusion with the wrong Rh factor or entry into the mother’s bloodstream through any contact (placental abruption, childbirth).

What do I advise such “negative” women? It is necessary to register with your obstetrician-gynecologist as soon as possible. It is advisable to be observed at the same time by a paid doctor. Do not skip a blood test to check for antibodies and their titers. With the help of ultrasound, you can detect the first signs of problems in the development of the fetus in time. Mommy must understand why the negative Rh factor is dangerous, and be very attentive to this feature of hers.

Rescue injection

On the first day after birth, doctors determine the Rh factor of the fetus. If it is positive, the woman is given anti-Rhesus immunoglobulin. This measure will help to significantly reduce the risks of incompatibility during future pregnancies. Therefore, a woman must independently control this moment, otherwise it will affect her ability to conceive and give birth to more children.

IN Lately an injection of immunoglobulin is administered during pregnancy at 28-32 weeks, provided that there is not the slightest amount of antibodies in the mother’s body. This prevention prevents the formation of antibodies in the mother.

If the relative amount of antibodies increases, then the woman in labor must be urgently hospitalized. IN in case of emergency specialists perform fetal blood transfusions monitored using ultrasound.

As a rule, when there is a conflict between the Rhesus of the mother and the child, doctors discuss the decision on the method of delivery, giving preference to a “caesarean section”. This reduces the chance of the baby's blood getting into the mother's blood.

Do not be afraid that the baby will spend the first days in the intensive care unit. If Rhesus is incompatible, the child may have three stages of hemolytic disease:

• anemic – the mildest form;
• icteric – the baby may have to stay on a drip;
• edematous - requires a blood transfusion.

Breastfeeding may be contraindicated for a baby in the first days after birth. It depends on his condition and bilirubin level. If doctors do not recommend breastfeeding your baby at first, express and save the milk. It still contains antibodies that can destroy the baby's red blood cells. But that's no reason to give up breastfeeding at all.

Rh conflict does not always develop during the second and subsequent pregnancies. It is important that such a woman treats her very responsibly, and competent prevention will help reduce all risks to a minimum.

For example, my neighbor is the “lucky” owner of Rh-negative blood, her husband is Rh-positive, and this did not prevent them from giving birth to three healthy children. And this is such happiness.

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See you again!

Always yours, Anna Tikhomirova