DE   EN   ES   FR   IT   PT


medicalmeds.eu Obstetrics Rhesus factor conflict

Rhesus factor conflict


Description:


About 85% of people are Rh-positive, they are called carriers of a rezusantigen. Other 15% of people which do not have this antigen are called Rh-negative. Rh-negative individuals do not possess also anti-agglutinin against this factor. Just the Rhesus factor antigen also differs from ordinary groups A and B and their combination in it. These antigens, as we know, have the corresponding agglutinins an alpha and a beta. But antirezusagglyutinina can develop in Rh-negative people that occurs if the Rhesus factor causing development of the corresponding agglutinins is entered into their organism. It can occur in two cases: if a Rhesus factor transfuse to the negative individual a Rh-positive blood, and still if the Rh-negative woman becomes pregnant a Rh-positive fruit from the Rh-positive man. In this case the placenta admits in the unique way of impact of Rh-positive antigen of a fruit on mother's organism in which then the corresponding antibodies develop.


Reasons Rhesus factor conflict:



Mother's sensitization at Rh-incompatible pregnancy occurs by means of transition of erythrocytes of a fruit, but not fabric of the placenta which is in direct contact with mother at all. Emergence of antibodies in an organism of the pregnant woman is caused by special antigen of a fruit. There is an isosensitization of a maternal organism. But here takes place of mother of a Rh antibody in turn pass into a fruit organism, affect erythrocytes and cause a serious illness, for example, a hemolitic disease of newborns in the form of various forms of anemia and jaundice.
From a fruit proteinaceous bodies of erythrocytes can also pass into mother's organism as Rh antibodies pass from mother to a fruit. For immunization of a maternal organism transition from a fruit of 0,3 ml of blood suffices. Erythrocytes of a fruit can pass into mother's organism together with particles of a fleecy cover which separation is possible in connection with any injury.
Incompatibility can become the reason of "fight" between "hostile" elements and it is easier for those if incompatibility is matched by development in a placenta of any pathological process. Rh-Hr antigen is connected, mainly, with erythrocytes though it is found in various bodies (a liver, kidneys, etc.), in also in saliva, milk, a gastric juice, fetal waters.

Патогенез резус-конфликта

Pathogeny Rhesus factor conflict


Symptoms Rhesus factor conflict:


The Rhesus factor is of particular importance in obstetrics as the Rh-negative woman herself suffers from an isosensitization, and also its fruit suffers during pregnancy in case of incompatibility with mother. At a Rhesus factor conflict between a fruit  relationship incompatible by birth as a result of which a serious illness of a fruit develops are established by mother. Under such circumstances it is always possible to expect death of a fruit and abortion before of time.
In an organism of the Rh-negative woman of an antibody can also develop in connection with transfusion of a Rh-negative blood, and the possibility of reaction of incompatibility after the first transfusion is not excluded. But this reaction most part happens weak and quickly takes place. Scientists explain it with the fact that erythrocytes eliminirutsya quickly and transfusion takes place asymptomatically or with weak symptoms. Such women at the subsequent childbirth give birth to children with the most severe form of an eritroblastoz – these mothers of a sensibilizirovana the previous transfusions and have to be under the special account during pregnancy.
At emergence of symptoms of anemia in the newborn, it is necessary to stop feeding him with mother's milk, and milk has to be investigated on Rh antibodies and it can be given only in the absence of those.


Treatment Rhesus factor conflict:


When ascertaining high risk a Rhesus factor conflict it is necessary to carry out its prevention in way introduction  of special anti-D of antibodies, for example, of the drug RhoGAM. This substance should be entered within 3 days after the delivery. Also its introduction is necessary during pregnancy if there was an injury of a stomach or any massive bleeding that can lead to mother's sensitization. This drug possesses the following mechanism of action – it "catches" mothers who got to blood fruit erythrocytes, and destroys them until response of immune system to them. Antibodies at passive immunization collapse in term up to 1,5 months.
Now in obstetric tactics of maintaining Rh-negative pregnant women there is a principle according to which RhoGAM enter all in the term of 28 weeks of a gestation, repeating an injection in 34 weeks.




  • Сайт детского здоровья