What is the danger of Rh-conflict during pregnancy and what to do about it

What is Rh-conflict and where does it come from

Let's start with the Rh factor. This is the name of The Rh Factor: How It Can Affect Your Pregnancy protein D ‑ antigen, which can be found on the surface of red blood cells - erythrocytes. The key word is "may." Some people have this protein - in this case, they say that their blood is Rh-positive (denoted Rh +). Some do not - they are Rh negative (Rh−).

Most people have Rh Incompatibility, Rh +.

The Rh factor is inherited, from parents to children, and generally has no effect on health or well-being. Nevertheless, it is necessary to know it. So, Rh + or Rh– must be mentioned when the blood group is established. This is essential for transfusion. If a person with Rh– gets positive blood with D ‑ antigen, his body will start producing D ‑ antibodies. And they, in turn, will begin to destroy "alien", Rh +, erythrocytes. This situation is called Rh-conflict.

Why Rh-conflict can happen during pregnancy

If the future parents have a positive Rh factor, there will be no conflict: the child will also inherit Rh +. But if a woman has a negative Rh factor, and a child has a positive one (for example, inherited from a “positive” father), a situation arises that doctors call Rh Incompatibility: Symptoms, Diagnosis & Treatments, Rh incompatibility.

Incompatibility does not necessarily develop into a Rh conflict. The blood of the mother and baby does not mix during normal pregnancy, so there is no reason for the mother to develop D ‑ antibodies.

Mixing of blood during pregnancy occurs only in rare cases. The Rh Factor: How It Can Affect Your Pregnancy, for example:

a woman is punctured to determine the condition of the fetus - amniocentesis or chorionic villus sampling;
uterine bleeding occurs;
a woman is injured in the abdomen;
doctors have to manually unfold the fetus in the uterus in order, for example, to transfer it from the breech presentation to the cephalic presentation for successful childbirth.

Also, contact with the blood of the fetus occurs during childbirth, abortion, miscarriage. As soon as this happens, the body of a mother with Rh− becomes sensitized with Rh Incompatibility: Symptoms, Diagnosis & Treatments, that is, sensitive to a positive blood group.

First-borns in most cases do not suffer from Rh Incompatibility from Rh-conflict with their mother. Only children from second and subsequent pregnancies are at risk.

If the second child also has a positive blood group, the sensitized mother's body starts sending D-antibodies across the placenta. They attack and destroy the fetal red blood cells.

What is the danger of Rh-conflict during pregnancy

When red blood cells break down, bilirubin builds up in the fetus's blood. A high level of pigment is manifested by jaundice: the child's skin and whites of the eyes turn yellow. This is the mildest Rh Incompatibility form of Rh conflict.

There may be more severe manifestations. Red blood cells carry oxygen, and if there are few of them, then the child's body begins to experience oxygen starvation. Serious anemia occurs, due to which the functioning of internal organs, including the heart and brain, is disrupted. The fetus may even die.

How to find out that you have a Rh-conflict with your child

It is impossible to determine the Rh-conflict by the well-being of a pregnant woman. Rh Incompatibility: mothers do not have symptoms. As a rule, the problem is detected on an ultrasound scan. A specialist detects in a child, for example:

Enlargement of the liver and spleen. These organs are responsible for the excretion of bilirubin from the body and undergo increased stress during Rh-conflict.
Swelling. They are caused by heart failure resulting from severe anemia.

If at the same time the mother has a negative blood group, Rh-conflict is diagnosed.

What to do if you have Rh-conflict during pregnancy

Rh-conflict is not treated. Therapy will be aimed only at eliminating its consequences Rh Incompatibility: Symptoms, Diagnosis & Treatments.

If ultrasound shows that the fetus is severely anemic, early labor (before 37 weeks of gestation) or a cord blood transfusion may be required while the baby is still in the woman's uterus. With a mild degree, childbirth can occur at the usual time.

How to prevent Rh-conflict during pregnancy

It is enough to track the factors that can cause the problem.

If you are pregnant, be sure to find out which Rh factor your blood has. As a rule, the gynecologist prescribes such an analysis at the very first scheduled examination.

If you have Rh−, more research is needed. In particular, the D ‑ antibody test. It is also carried out according to the doctor's prescription and helps to find out whether the mother's body has begun to attack the fetus. If the mother does not have D ‑ antibodies, the baby is safe.

If the mother and fetus are diagnosed with Rh incompatibility, the woman may be prescribed Rh immunoglobulin. This medicine prevents the body from making antibodies if they have not already been made. Typically, an Rh ‑ immunoglobulin injection is given at 28 weeks. The Rh Factor: How It Can Affect Your Pregnancy | ACOG of the first pregnancy and within 72 hours of the birth of an Rh-positive baby. Each subsequent pregnancy may require a repeated dose, but in any case, the decision to prescribe Rh-immunoglobulin is made only by the doctor.