Can a child be Rh negative? How is the Rh factor inherited in humans? Both parents are Rh positive

According to the level of antibodies in the blood of a pregnant woman, the doctor can draw conclusions about the alleged Rh factor in the child and determine the beginning of the Rh conflict.

Rh conflict prevention

At the risk of a Rh conflict, a woman is repeatedly examined for the presence of Rh antibodies during pregnancy. If they are not there, then the woman is not sensitized and there will be no Rh conflict in this pregnancy. Immediately after birth, the Rh factor in the baby is determined. If Rh is positive, then no later than 72 hours after birth, the mother is injected with anti-Rhesus immunoglobulin, which will prevent the development of the Rh conflict in a subsequent pregnancy.

Anti-Rh immunoglobulin breaks the immunological chain and prevents the production of anti-Rh antibodies. Also, this drug binds aggressive antibodies formed in the mother's blood and removes them from the body. Timely administration of anti-Rh globulin with a high degree of probability prevents the development of Rhesus conflict during subsequent pregnancy.

You will do the right thing if you find out in advance at the hospital where you plan to give birth, if they have anti-D-immunoglobulin (of course, if you have a negative Rh factor), if they do not, buy in advance and take it with you!

Recently, the same vaccine has been administered for prophylaxis during pregnancy (between the 28th and 32nd weeks), provided that the pregnancy proceeds safely and antibodies are not detected in the blood of the expectant mother. After the administration of the drug, the blood for antibodies is no longer examined.

The same immunoglobulin prophylaxis for women with a negative Rh factor should be carried out within 72 hours after:

- ectopic pregnancy;
- abortion;
- placental abruption;
– amniocetosis (an examination performed by inserting a long thin needle through the abdominal wall into the uterus);
- spontaneous miscarriage;
- blood transfusions.

If the woman does have Rh antibodies and the fetus is Rh positive

If a woman has Rh antibodies in her blood and their titer increases, then this indicates the presence of a Rh conflict.

The mother's antibodies cross the placenta and "pounce" on the baby's red blood cells. At the same time, a large amount of a substance called bilirubin appears in his blood. Bilirubin turns a baby's skin yellow ("jaundice") and can damage the baby's brain. As the fetus's red blood cells are continually being destroyed, the liver and spleen try to speed up the production of new red blood cells while growing in size. In the end, they can not cope with the replenishment of red blood cells. Severe oxygen starvation (anemia) sets in - the content of red blood cells and hemoglobin in the blood becomes dangerously low, which can lead to a number of serious disorders in the fetus. This condition is called hemolytic disease.

In the event of a Rh conflict, treatment is necessary in a specialized perinatal center, where both the woman and the child will be under constant supervision.

If it is possible to bring the pregnancy to 38 weeks, a planned caesarean section is performed. If not, they resort to intrauterine blood transfusion: they penetrate the umbilical cord vein through the anterior abdominal wall of the mother and transfuse 20-50 ml of erythrocyte mass to the fetus. The procedure is carried out under ultrasound guidance.

In emergency cases, within 36 hours after the birth of the baby, an exchange blood transfusion is performed, he is injected with Rh-negative blood of the same group as his mother, and resuscitation is carried out. The mother of such a child is not allowed to breastfeed him in the first days. This is due to the fact that with the mother's milk, the newborn gets anti-Rhesus antibodies that she formed during pregnancy. And these antibodies tend to destroy the baby's red blood cells.

Summarize

As soon as you decide to have a baby, take a blood test to determine the Rh factor. And this should be done not only by you, but also by your partner. If the future father has a positive Rh factor, and the mother has a negative one, then the probable Rh factor of the fetus is determined as 50% to 50%. In this case, a couple planning to become parents should consult a doctor: he will tell the expectant mother what preventive measures can prevent the development of the Rhesus conflict. Do not neglect the advice of your gynecologist, listen to him and follow all the instructions that he appoints. If the doctor, looking at the results of the tests, said: "Rhesus negative", do not be discouraged! If you are a vigilant and responsible mother, everything will be fine with your child.

Despite the prevailing stereotype that all people are initially equal, yet nature itself endowed all of us with distinctive individual features. Therefore, we differ from each other in color type, complexion, temperament ... But, if the hair color and even the figure can be changed at will, then there is a classification according to which you will not be able to change the “environment” under any circumstances and go to another category. We are talking about four blood groups and only two variants of the Rh factor. These innate parameters cannot be changed during life at one's own discretion and they are given once and for all. Moreover, throughout life they have a direct impact not only on you, but also on your children and grandchildren. Therefore, they should be taken with all seriousness. Especially to the Rh factor, because its importance is almost equal to the importance of all other blood characteristics in the aggregate. And they, in turn, are a direct reflection of the genetic code of each person, that is, in fact, his life, health, appearance, longevity, etc. Thus, it becomes clear that the Rh factor strongly affects the offspring, as one of the most important stages and tasks of the body. But how exactly?

There are other systems for assessing and analyzing blood systems, and their number is constantly increasing. But they are of interest mainly to specialists (researchers-biochemists, physicians, geneticists), and most people have never heard of them, and do not need this information. But everyone knows about the Rh factor, both men and women. The former can open their passport at any time and see a seal indicating the blood type and Rh factor, made in the military registration and enlistment office with the start of military age. The latter will definitely encounter or have already encountered this concept as soon as they think about pregnancy and the birth of a child. The modern education system introduces students to the concepts of blood group and Rh factor in the basic course of human anatomy. But, to be honest, school knowledge is often perceived by us as something imposed and often perceived inattentively, forgotten soon after passing the test and receiving an assessment on the relevant topic. And only with age and entry into adulthood, the value of this or that information is revealed to us in a new light. Fortunately, today there are no problems with access to any information, and as for such important knowledge about your own body as the blood type and its Rh factor, then every doctor will be happy to tell you about them. We offer to refresh your knowledge right now, without looking up from your computer screen.

What is the Rh factor. How to determine your Rh factor
The Rh factor (abbreviated to simply Rhesus or Rh) is one of the 29 blood group systems used worldwide today. For example, the AB0 system (or the first, second, third and fourth blood types) is the most common characteristic for assessing human blood, and the Rh factor is considered to be the second most important system in terms of clinical importance. Unlike blood groups, of which there are four, the Rh factor is characterized by only two options. It is either positive (Rh+) or negative (Rh-) - which is determined, respectively, by the presence or absence of a special antigen protein (or, in scientific terms, lipoprotein) on the surface of blood erythrocytes. In fact, there are more than 40 such antigens, and each of them is designated by its own code, consisting of numbers, letters and / or other symbols. But in determining the Rh factor, antigens of the so-called type D and, to a lesser extent, types C, E and e, play a key role. Their presence or vice versa absence determines the Rh status of a person. It is known that the vast majority of the population of our planet, more precisely 85% of Europeans and literally 99% of Asians, have a positive Rh factor, that is, there is a named protein on the surface of their red blood cells. And 15% of people, and half of them, that is, as many as 7%, are natives of Africa, do not have Rhesus, that is, their Rh factor is negative. But even "Rh positive" people can have different Rh status.

The fact is that, as with a combination of chromosomes that affects the formation of the sex of the unborn child, we also get the Rh factor from our parents. And each of them, in turn, also has data received from his parents. Thus, if in the blood of both parents the Rh was dominant, then the child will receive the Rh + factor, that is, a positive Rh factor. The Rh factor Rr, that is, inherited from one parent with dominant and one with recessive Rh, will also be dominant, but will behave differently when combined with other genomes in the future. And only if both parents have a negative Rh factor, then the child can also be only Rh-negative: rr. Although the Rh factor of both grandparents will also definitely affect. Too difficult? Let's look at an example. Suppose that the father of the unborn child has a positive Rh, and the mother is negative. But there is also a grandmother with a negative Rh. That is, we have the following initial data: father Rr and mother rr. A child in this case can be born with an Rh factor of both Rr and rr with a probability of 50/50. If both parents are Rh positive, but both grandparents are Rh negative, then the children will receive the same number of both dominant R and recessive r genes. And they can get the Rh factor of any of the options: RR (Rh +), Rr (Rh +), rr (Rh-). But note that the probability of a positive Rh factor will still be three times higher than the probability of a negative one: 75% versus 25% probability. In the office of the gynecologist-obstetrician, you can see a visual table, where at the intersection of different indicators of the Rh factors of the parents, the variants of the Rh factors of the unborn child are indicated. The same visual information is easy to find on the Internet in order to find out in an accessible form the chances of your heir to have a positive or negative Rh status.

But at the same time, these tables, and even a blood test for the Rh factor, will make it possible to find out only one fact: a positive or negative Rh factor in the owner of the blood. More accurate data, that is, the presence of dominant and recessive traits in generations, can only be ascertained as a result of more conducted exclusively in specialized clinics and / or genetics institutes. You can, of course, try to use the logic "from the opposite" and calculate the type of Rh status from children, but it is unlikely that anyone will do such painstaking calculations. It is enough to know that the owners of a negative Rh status under no circumstances can carry a positive Rh in their genome and, accordingly, pass it on to their descendants. A positive Rh always tends to dominate and as a result gives a positive Rh status. And in general, genetics knows only three circumstances for the inheritance of Rh status:

1. Both Rh negative parents can only give birth to a child with the same Rh negative as theirs.
   
2. One Rh-positive parent and one Rh-negative parent have a chance of both Rh-positive and Rh-negative offspring, with a Rh-positive baby having a six-in-eight chance of being born, while a non-Rh child antigen - only in two cases out of eight.
   
3. Two Rh-positive parents with a probability of 9 out of 16 will give birth to Rh-positive children with completely dominant Rh children, with a probability of 6 out of 16 - Rh-positive children with the makings of recessive and dominant traits, and only in one case out of 16 their child will have a negative Rh -status.
   

In total, there are only 9 possible ways of inheriting the Rh factor, and you and your children, as well as parents, belong to one of them. You can find your option in the list right now:

1. 100% of children will have a Rh-positive blood factor - Rh + (DD)
   

2. Mother is Rh-negative - Rh-(dd)

   The father has a Rh-positive factor factor - Rh + (DD)

3. 50% of their children will be Rh positive - Rh + (DD),

   50% of their children will be Rh positive - Rh+(Dd).
   

4. The father has a Rh-positive factor - Rh + (Dd)

   25% of their children will have a Rh-positive factor - Rh + (DD),

   25% of their children will be Rh-(dd) negative.
   

5. The father has a Rh-positive factor - Rh + (Dd)

6. The mother has a Rh-positive factor - Rh + (DD)

   100% of their children will be Rh positive - Rh+(Dd).
   

7. The mother has a Rh-positive factor - Rh + (Dd)

   50% of their children will have a Rh-positive factor - Rh + (Dd),

   50% of their children will be Rh negative - Rh-(dd).
   

8. Mother is Rh-negative - Rh-(dd)

   Father is Rh-negative - Rh-(dd)

   100% of their children are Rh-(dd) negative.
   

Why go into all this complexity? Why do you need to know and take into account the Rh factor, your own and your relatives? When and why might this information be useful? First, the combination of dominant and recessive traits and the resulting heterozygosity of the organism is stored in the genes and can influence the formation of many subsequent generations. Secondly, genetic features, including the Rh factor, do not exist on their own, but are inextricably linked with the physiological and anatomical features of the fetus, child, and then an adult. The color of the hair and eyes of the unborn baby, the shape of the teeth and the tendency to early baldness, the presence of musical abilities and the likelihood of ambidexterity, genetics has already learned to determine long before the birth of a little man. But if these signs are more likely to be in the sphere of curiosity of parents, then the importance of early detection of genetic and / or inherited diseases and other abnormalities cannot be overestimated. Dominant and recessive traits, including the Rh factor, are determined even during fetal development. And it is necessary to know the Rh statuses of a couple who planned to become parents because of the existence of such a phenomenon as a Rh conflict. Its probability is determined even before the planned pregnancy begins in order to avoid major problems during gestation.

What is Rhesus conflict. What to do with Rhesus conflict
Rh conflict is an incompatibility between the blood of the mother and the child according to the Rh factor. You ask how this is possible, because a child is the fetus of the mother's body and the result of crossing her genes with the father's genes?! This is precisely why the discrepancy occurs: when a child's positive Rh factor, inherited from the father, "meets" the mother's negative Rh factor. A situation that is paradoxical at first glance and completely logical in a judicious analysis is emerging. Just remember, as it was indicated at the beginning of the article, that a positive Rh factor is nothing more than the presence of a certain protein in the blood. The body of a pregnant woman with a negative Rh factor "does not know" about the existence of such a protein, it does not have it itself and has never encountered it. Therefore, when the Rh-positive blood of the fetus enters the mother's body, the mother perceives this protein as something alien and potentially dangerous to herself. And if so, it begins to produce antibodies against fetal erythrocytes, which carry the antigen protein responsible for the Rh factor. Of course, maternal and fetal blood do not mix directly. But their organisms inevitably exchange metabolic products, some cells and substances through the permeable walls of the placenta. In the same way, antibodies against a protein in the blood of a child with a positive Rh factor are sent to him from the mother. This protective mechanism, biologically verified and deeply “programmed” in a person, cannot be stopped, and the longer the conflict of Rh factors lasts, that is, in fact, organisms, mother and fetus, the greater the number of antibodies hostile to the fetus. This carries a direct danger to the health of the baby, so doctors always find out in advance which Rh factor each of the future parents has.

The erythrocytes of the fetus, attacked by the antibodies of the mother's body, die and turn into decay products, toxic and poisoning the blood, cells, organ systems, and most importantly, the brain of the embryo. One of the most concentrated substances - bilirubin - gives the baby's skin a yellowish color. Hence the term neonatal jaundice, which is actually a hemolytic disease (that is, a disease of destruction) of newborns. This must be understood in such a way that, of course, not babies are destroyed, but their blood cells. However, the harm from this is still considerable. In addition to the brain, the liver and spleen of the baby suffer, then other internal organs and their systems. Fortunately, modern medicine has reached a sufficient level of development to counter these dangers. At the first suspicion of the possibility of a Rh conflict, a pregnant woman becomes under the close supervision of specialists, and if Rh antibodies are detected, special measures are taken to smooth out the incompatibility of the blood of the mother and fetus. Subject to timely diagnosis and disciplined implementation of the doctor's instructions, a successful resolution of the Rh conflict is more than likely. To do this, in women with a negative Rh factor, the presence of antibodies in the blood is checked starting from the 8th week of pregnancy: it is at this time that the fetus shows its Rh factor. If necessary, a drug containing anti-Rhesus immunoglobulin is introduced into the body. In other words, the Rh factor, although it is inherited in a recessive-dominant type and cannot be changed, but with the right approach and sufficient awareness, this does not threaten health at all - neither yours nor your loved ones. So know your body, love yourself and be healthy!

It is no secret that bearing a child is a difficult process and is fraught with many dangers and nuances, for example, a negative Rh factor in a woman during pregnancy. If you believe the statistics, many lives were taken away by the lack of knowledge of what blood type and Rh factor a person has. This is one of the most common miscarriage factors. Every expectant mother should have an idea about the Rh factor, the Rh conflict, as well as other nuances of this pathological process.

The concept of the Rh factor and the Rh conflict

Blood is one of those human systems that is constantly under the scrutiny of scientists. From time to time new systems are found in it. The most important and widespread blood system is the ABO system. In it, experts identified a specific antigen D, which is responsible for the Rh factor.

According to the localization of the D antigen, it is possible to safely establish the Rh factor of the circulatory system. If D is found on the outside of the red blood cells, then the Rh factor is positive. If a person does not have this antigen, then it is negative.

Due to the presence of this antigen, the Rhesus of the subject is determined. In the presence of modern equipment, this diagnosis does not take much time and is not very expensive.

The chance that a child will be Rh positive if the mother is Rh negative and the father is Rh positive is 65%.

It is a positive Rh in the fetus and the absence of one in the mother that can provoke an Rh conflict, since the body of a woman and the fetus constantly exchange various substances and substances through the blood system.

Everything happens as follows. The blood of the fetus enters the mother's body during blood exchange. The woman's immune system detects antigen D in the incoming blood, defines it as foreign and produces antibodies that harm the child by destroying its circulatory system.

It is important for every person, especially a woman, to know their Rh factor and blood type. This data is most often required during emergencies and can save a person's life.

The effect of Rh negative on pregnancy

But Rh conflict does not only occur with an Rh-positive father.

• the fact of the second conception with the presence of such a reason, the factor is negative in a pregnant woman;
• the penetration of the baby's blood into the woman's body during the first pregnancy;
• transfusiology of blood into the mother's circulatory system before pregnancy, if the Rh factor was not taken into account;
• various pathological processes during the period of bearing a child: exfoliation of placental tissues, internal hemorrhages;
• the presence of diabetes mellitus in women with pregnancy.

Naturally, you need to know your RH to always be ready for any force majeure, but nevertheless, the percentage of good births in Rh-negative women is very high, especially in the absence of the D antigen and the father of the child.

Blood during pregnancy at a later date should be taken frequently in order to detect the pathology in time and proceed to eliminate it.

During the first pregnancy, the chance of pathology due to the Rh factor is extremely small, because the mother's immune system has not yet formed a system of antibodies to the D antigen in the fetus, and with minimal therapy, the birth will go smoothly.

There may be a risk of a lack of blood in the child, but a conventional transfusion can solve this problem. In this case, the woman should be under the strict guidance of a gynecologist in order to avoid problems with the fetus.

At a certain point in pregnancy, there is a period that is characterized by a peak in the production of specific antibodies to the fetal antigen. At this point, you can make one injection, which is called immunoglobulin. It belongs to the gamma globulin fraction and its function is to prevent the development of maternal antibodies to the fetus in the future. This is very useful if parents are planning a second pregnancy.

If you do not administer this drug to a woman, then with the advent of a second pregnancy, the likelihood of a Rh conflict increases significantly and carries consequences much worse than a mild form of anemia in a newborn. We are talking about a very terrible pathology - hemolytic disease. All red blood cells are susceptible to destruction, the level of bilirubin rises and jaundice can be observed. The fetal brain is also damaged. The chance of giving birth to a healthy child, even with the necessary assistance, is very small.

It is worth appreciating the importance of the immunoglobulin vaccine after the first pregnancy, because there are often cases of artificial termination of pregnancy, because in some cases, bearing a fetus is not humane in relation to parents or a baby. If an abortion was performed on a woman who has a negative Rh factor, then a new pregnancy should not be discussed, because the consequences can be fatal.

Medicine does not stand still, and immunoglobulin very well solves the problem with the developed antibodies of the mother to the fetus. Therefore, you need to make your plans for pregnancy in advance and in consultation with your doctor.

Features of the management of pregnant women with negative Rh

Pregnant women who are suspected of having a Rhesus conflict with the fetus need to go to bed as soon as possible in order to constantly be under the round-the-clock supervision of doctors who, in which case, will be able to provide the necessary emergency assistance.

But there is also the possibility that the pregnancy will be completely normal. The reason for this may be a reduced level of immunity in the mother, who will not be able to develop the required amount of antibodies in response to fetal antigens in a short time. But this has its drawbacks, because with a weak immune system, the risk of infectious and viral diseases is high, which can adversely affect pregnancy.

Antibodies should be monitored at least once a week. This will help to diagnose the Rh conflict in a timely manner and take urgent action to save the mother and baby.

It is worth noting that the negative Rh factor during pregnancy depends on the blood type. That is, it can be argued that blood type and pregnancy are directly proportional to each other. A negative blood type during pregnancy is the main cause of the problem. So, 1 negative blood group and 3 negative blood group cause Rh-conflict more often than group 2. The third group, although it does not occur often enough, but the chance of a Rh conflict, if present, is very high. With the 4th blood group, the Rh conflict does not occur, since there is no reason in the form of agglutinins. The fourth blood type of the mother is the most favorable, and it is with the fourth group that you can not be afraid to get pregnant.

Rhesus conflict has a negative impact on the fetus, the consequences of which he can remain for life.

• diseases of the blood and cardiovascular system;
• diseases of the liver and gallbladder in the form of hepatitis and jaundice;
• diseases of the nervous system;
• increased risk of diseases that have a hereditary predisposition.

But do not despair. Modern medicine has found more than one method of dealing with the Rh conflict, pregnancy with a negative Rh factor is possible and the consequences are not terrible if you follow some important rules.

Prevention and treatment of negative Rh factor

Until a few decades ago, women with a negative Rh factor were recommended to give birth to only one child, and doctors were categorically opposed to terminating the pregnancy with the first baby.

Today, the situation is completely different, which cannot but rejoice. With the help of preventive methods with a negative blood group in a woman during pregnancy, she has the opportunity to freely plan for the birth of the following children.

1. It is necessary to eliminate the production of specific antibodies by the woman's body or reduce their number.
2. It is necessary to abandon certain procedures that increase the risk of fetal blood entering the mother's circulatory system.
3. Use immunoglobulin injections if needed.

• appointment of a blood test for the presence of antibodies in the first trimester of pregnancy;
• with a high titer, you need to repeat the tests every week;
• constant monitoring of the fetus through tests and ultrasound examination;
• if it is impossible to carry out a blood transfusion to the fetus, then it becomes necessary to induce labor, since any delays are dangerous for the life of the baby;
• a woman should be vaccinated only after cases such as abortion or conception outside the uterus.

It is important to remember that during the first birth, the child is most often not in danger if the woman has not received transfusions of Rh-positive blood. The second birth is much more dangerous in terms of the occurrence of pathologies, but this can be avoided if the woman is given immunoglobulins in time.

Do not panic, because modern medicine has gone far ahead and the problem with a negative Rh factor during pregnancy is easily solved. The main thing is that you need more time to be under the supervision of doctors and monitor your health and the health of your baby.

Everyone is aware that the Rhesus conflict is bad, but few people know how it manifests itself and what it threatens. Unfortunately, the concept of this problem appears only when we are faced with its negative consequences, although they could have been avoided. That is why it is necessary to understand this issue.

The Rh factor is a system of human antigens that is located on the surface of the red blood cell. If the Rh factor is present in the blood, then “Rh positive” is determined, if it is not, then “Rh negative”.

Many women find out about their blood type and the Rh factor already when they are pregnant, when they register at the antenatal clinic. Remember that the blood type and Rh factor do not change throughout life, and you need to know them as early as possible, for this it is enough to donate blood from a vein once.

What is Rhesus conflict?

If during pregnancy Rh-positive erythrocytes of the fetus enter the body of a woman with Rh-negative blood (we will talk about the reasons later), then her body begins to produce antibodies in response to a foreign antigen.

Re-entry of Rh-positive erythrocytes already causes a massive formation of Rh antibodies, which easily overcome the placental barrier and enter the bloodstream of the fetus, causing the development of the fetus and newborn. The antibodies are directed against the Rh factor on the surface of the erythrocyte and lead to the destruction of the fetal erythrocytes.

Severe anemia develops in utero, which leads to tissue hypoxia, enlargement of the spleen and liver, and dysfunction of the internal organs of the fetus. When an erythrocyte is destroyed, a large amount of bilirubin enters the bloodstream, which, being deposited in the brain, leads to encephalopathy and kernicterus. Untreated anemia and dysfunction internal organs steadily progressing, the terminal stage of fetal hemolytic disease develops - edematous, in which fluid accumulates in the chest and abdominal cavity. As a rule, at this stage the fetus dies in utero.

It is worth noting that the Rhesus conflict is one of the reasons, but never affects conception and miscarriage in the early stages.

When should you be afraid?

Mom is Rh-positive - Dad is Rh-negative: there is no reason to worry, this situation does not affect either conception, or gestation, or childbirth.

Mother is Rh-negative - Father is Rh-negative: there will be no problems either, the baby will be born with Rh-negative blood.

Mom is Rh-negative - Dad is Rh-positive: this situation requires special attention not only of doctors, but also of the woman herself, since your health is in your hands, and all subsequent information is extremely important for you.

Women with Rh-negative blood should be very responsible approach to the issue. Remember that every unwanted pregnancy increases the risk of not having a baby in the future.

Situations leading to the development of Rhesus conflict

As mentioned above, the starting point for the development of the Rh conflict is the entry of Rh-positive erythrocytes of the fetus into the bloodstream of the Rh-negative mother.

When it's possible:
artificial termination of pregnancy () at any time;
spontaneous miscarriage at any time;
;
after childbirth, including after;
nephropathy (preeclampsia);
bleeding during pregnancy;
invasive procedures during pregnancy: cordocentesis, chorionic villus sampling;
abdominal trauma during pregnancy;
a history of blood transfusion without taking into account the Rh factor (currently this is extremely rare).

All the situations described require specific prophylaxis, the introduction of anti-Rhesus gamma globulin.

Prevention of Rhesus conflict

The only proven method of preventing Rhesus conflict at present is the introduction of anti-Rhesus gamma globulin - and patients should remember this first of all! All situations described above require the administration of anti-Rhesus gamma globulin in the first 72 hours but the sooner the better. For high efficiency of the preventive action, it is necessary to strictly observe the timing of the drug administration.

Pregnancy in a woman with Rh negative blood

After registration in a patient with Rh-negative blood, it is recommended to determine the titer of anti-Rh antibodies in the blood every month, starting from early pregnancy.

The first signs of a possible hemolytic disease of the fetus are determined by the results of ultrasound on - pregnancy.

Home " Life " If the parents are Rh positive. Negative Rh factor in a child - the norm or pathology

When does a pregnant woman usually first think about such a concept as "Rhesus conflict"? Usually when she finds out she has Rh negative blood. And questions arise: what is it and is it possible to avoid Rh-conflict during pregnancy?

These questions are answered by Maria Kudelina, a doctor, Rh-negative mother of three children.

What is Rh conflict during pregnancy?

Rhesus conflict is possible during pregnancy. This is a conflict between the mother's immune system and the child's blood, when the mother's immune system begins to destroy the elements of the child's blood (erythrocytes). This happens because there is something on the baby's red blood cells that is not on the mother's red blood cells, namely the Rh factor. And then the mother's immune system perceives the child's red blood cells as something alien, like bacteria and viruses, and begins to destroy them. This can happen when the mother is Rh-negative and the baby is Rh-positive.

According to statistics, approximately 15% of people are Rh-negative, and 85% are Rh-positive. Rh conflict is possible during pregnancy when the mother is Rh-negative and the child is Rh-positive. If Both parents are Rh negative, then the child will also be Rh negative and the conflict is excluded. If the father is Rh-positive, with an Rh-negative mother, the child can be both Rh-negative and Rh-positive.

When does Rh conflict occur during pregnancy?

Suppose the mother is Rh negative and the child is Rh positive. Is it necessary to have an Rhesus conflict during pregnancy? No. For a conflict to occur, it is necessary that Rh-positive blood entered the blood of an Rh-negative mother. Normally, this does not happen during pregnancy, the placenta does not allow blood cells to pass through.

In what situations is this possible?

Rh-incompatible blood of a child can get into the Rh-negative blood of the mother in the following cases:

• during a miscarriage,
• medical abortion,
• ectopic pregnancy,
• if a woman has bleeding during pregnancy.

A conflict is also possible if mothers have ever had Rh-positive blood transfusions before. It is also possible for the baby's blood to reach the mother during normal births.

Thus, during first successful pregnancy, the risk of Rh conflict is very small. A tangible risk occurs with repeated pregnancies.

Rh immunoglobulin - how it works

Modern medicine has the ability prevent rhesus conflict when Rh positive blood enters the mother's blood. Most often, Rh conflict can be prevented by injecting anti-Rh immunoglobulin (Rho D immunoglobulin) into an Rh-negative mother. within 72 hours of exposure to Rh-positive blood before the mother's own antibodies have developed.

This usually happens after childbirth if anti-Rhesus antibodies were not detected in the mother's blood during pregnancy. You can not give an injection if, according to the result of a blood test of a child, it turns out that he also has a negative Rh.

With the introduction of synthetic immunoglobulin, the erythrocytes of the Rh-positive fetus that enter the mother's body are destroyed before her own immune system has time to respond to them. Mom own antibodies to the child's erythrocytes are not formed. Synthetic antibodies in the mother's blood are usually destroyed within 4-6 weeks after injection. And by the next pregnancy, the mother's blood is free of antibodies and is not dangerous for the baby. While own maternal antibodies, if formed, remain for life and can lead to problems in subsequent pregnancies.

Prevention of Rh conflict is carried out by the attending physician, taking into account individual characteristics each case.

What to do for Rh-negative women during pregnancy

During pregnancy in an Rh negative woman blood tests every month for the presence of anti-Rhesus antibodies in her blood. If anti-Rhesus antibodies appear in the blood of a pregnant woman, this indicates that the blood of a Rh-positive child has entered the mother's blood and a Rh conflict is possible. In these cases, the doctor's observation of the course of pregnancy and the condition of the child becomes more thorough, you need to regularly do blood tests to measure the level of antibodies (antibody titer in Rh conflict). If anti-rhesus antibodies are not detected during pregnancy, this means that everything is fine, there is no Rh conflict and nothing more needs to be done before the birth.

What to do after childbirth

Ideally, after childbirth, the child will be taken as soon as possible blood analysis and determine the blood type and Rh factor. In Russian maternity hospitals, blood is most often taken from a child from a vein. If the baby turns out to be Rh negative, the mother can be very happy and she does not need to inject anything in this case.

If the child is Rh positive, and the mother did not have anti-Rhesus antibodies during pregnancy - to prevent a possible Rh conflict during the next pregnancy, an intramuscular injection is made with anti-rhesus immunoglobulin within the next three days until my mother's immune system has had time to start producing its own antibodies. This drug can be bought as prescribed by a doctor in a pharmacy after childbirth, if it is not in the hospital. Ask relatives to help you and control this important issue for you, if necessary. remembering your Rh factor your doctor in the maternity hospital.

If the antibodies in the mother's blood have managed to develop, then thanks to the immune memory they will remain for life. What does it threaten? In subsequent pregnancy increases the likelihood of Rhesus conflict- hemolytic disorder, which can lead to various consequences: from neonatal jaundice and the need for blood transfusions to miscarriages, premature births and stillbirths. Fortunately, there are modern methods of treatment. But still Rhesus conflict is easier to prevent than to treat.

Rhesus conflict and breastfeeding

In cases where there is definitely no Rh conflict (mother and child with the same Rh-negative blood or the child is Rh positive, but no signs of Rh conflict were detected during pregnancy), breastfeeding is no different.

Jaundice after childbirth is not a mandatory sign of conflict, so you should not focus on it. Physiological jaundice appears in a newborn not because of a Rh conflict or breastfeeding, but as a result of replacing fetal hemoglobin with a normal human one. Fetal hemoglobin is destroyed and gives yellowness to the skin. This is a normal physiological situation, usually not requiring intervention.

If the Rhesus conflict nevertheless arose, then modern medicine has enough ways to help the child. Even diagnosis of hemolytic disease is not a contraindication To breastfeeding. These children need more frequent and prolonged breastfeeding.

Prohibition of breastfeeding in case of hemolytic disease, as a rule, is associated with the fear that the antibodies contained in milk will exacerbate the situation. However, under the influence of the aggressive environment of the stomach, the antibodies that got into the milk are destroyed almost immediately. Based on the condition of the child, the doctor determines the possibility and method of breastfeeding: whether it will be sucking from the breast or feeding with expressed milk. And only if the child's condition is severe, he can receive nutrition in the form of solutions injected into the vein.

There may or may not be a conflict.

For women with Rh-negative blood, it is especially important that the first pregnancy proceeds safely and ends with a successful birth. Should be done after childbirth a child's blood test for group and rhesus. And if the child is with Rh-positive blood, and antibodies were not found in the mother, anti-Rhesus immunoglobulin is administered to her over the next three days. With the second and subsequent pregnancies, it is also necessary to control the absence of antibodies in the mother's blood.

Be careful and everything will be fine!

Rh factor is a certain property of red blood cells, and it is inherent in most people. If a person's blood has this property, then it is called Rh-positive. If this property is absent in red blood cells, it is called Rh-negative.

And if for human health the absence or presence of the Rh factor does not matter, then there are a number of situations, the role of these properties becomes extremely large.

For example, this is very important for a pregnant woman with Rh-negative blood. her child's blood will be Rh-positive, then there is a high probability of developing a conflict, which poses a great danger to the newborn.

Studies show that the Rh factor is inherited, and, in accordance with the general laws of heredity, a child inherits one trait from mothers, and the second from father, therefore, the group properties of his blood, including the Rh factor, are composed, as it were, of two “halves”.

If a woman's blood is Rh-negative, and her husband's blood is Rh-positive, and these "halves" are in some sense different, then what will happen?

Studies show that the Rh positive factor is able to suppress the signs of the Rh negative factor, which makes it unrecognizable, the consequences of which can be quite important.

For example, a woman has blood Rh negative, and the man Rh positive, but she has a masked Rh-negative trait. The child, inheriting in equal measure inherits from the father a clear positive and latent negative factors, but, in combination with the mother's negative, the child will have Rh-negative blood.

According to the same laws of heredity, an amazing case is also possible when parents with Rh-positive blood have a child whose blood is Rh-negative.

This is explained by the presence of a latent Rh-negative trait in the mother and father. If they give the child obvious Rh-positive properties, then the baby will have the same Rh-positive blood. However, if both of them reward the child with their masked Rh-negative factors, which in combination become obvious, then a paradox will be observed in which both parents have Rh-positive blood, and the child is Rh-negative.

If both spouses have Rh-negative blood, then the child will have the same blood.. This is a good option, in which the Rhesus conflict will not occur. This coincidence is happy, but rare, since Rh-negative blood is not so common - about 15% among Europeans and no more than 5% among Asians.

But even if a man has Rh-positive blood, the child is not necessarily in danger, and practice shows that most children are born healthy. Talking about the danger, doctors talk about the risk, or the likelihood of an Rhesus conflict.

During pregnancy, the mother and are combined into a single biological system, but between them there is also a border outpost in the form of a placenta, which protects from harmful factors fetus. These factors may come from the mother's body, but at the same time, the mother is also protected from dangerous influences from the fetus. It is the placental barrier that makes it possible to successfully resolve most of the Rh-incompatible pregnancies.

But sometimes this barrier turns out to be faulty, in which case they penetrate through the placenta into the mother's body fetal erythrocytes. If the blood of the child and the mother is incompatible with the Rh factor, then the erythrocytes of the fetus are foreign to the mother, and the body's immune system includes protective reactions against everything foreign. Rh antibodies arise and begin to eliminate incompatible red blood cells, and this does not only occur in the mother's bloodstream. Penetrating into the blood of the fetus, they carry out their destructive work there. The result may be intrauterine damage to the fetus, and

Children are inherited not only similar to the parental appearance and figure. They receive a whole genetic set of father and mother, the same applies to such phenomena as the development and functioning of the body, all kinds of hereditary diseases of systems and organs, even the smallest details (for example, the structure of hair and nails). Blood and its parameters are no exception. Many nuances are associated with the Rh factor of blood during conception and further pregnancy.

What is the Rh factor?

The blood type and Rh factor (Rh) in humans are unchanged throughout life. These characteristics, which are inherited, are laid down during pregnancy. Rhesus is formed already at 7-8 weeks after conception. Not every pregnant woman knows exactly what effect a parameter can have on bearing a child and on the ability to become pregnant.

First you need to understand what the Rh factor means. It refers to a protein that is localized in red blood cells. Its presence makes the Rh factor positive, the absence - negative. This parameter does not affect the life of a person or his health.

Problems arise when a woman and a man are planning to conceive, because of the risk of conflicting Rh factors. Different Rh factors are rare, because. 85% of people have protein in the blood, and only the remaining 15% are born with a negative indicator.

The parameter got its name in honor of a macaque named “Rhesus”, which took part in research experiments. To designate it, it is customary to use the Latin letter D. If it is positive, they put the capital letter D (it is dominant), negative - d (denotes a recessive gene).

positive and negative

The combination of existing Rh factors gives the child one of the options, positive or negative. There are 3 possible combinations:

It would seem that a positive Rh factor, connecting with a negative one, suppresses it, being a dominant gene, and the baby should be with a positive parameter. This does not happen in all cases of such a combination. The result of different Rh factors in parents periodically becomes a negative gene in a newborn baby. Sometimes, even if both have positive blood characteristics, a child can be born with a negative gene. There is no need to accuse your spouse of treason, because this is quite normal.

The main danger in the mismatch of Rh factors in mother and father is due to the development of Rh conflict during pregnancy. This is fraught with serious consequences. The protein in the baby's blood is perceived by the mother's body with a negative Rh as a foreign element, which provokes the production of antibodies, the action of which is aimed at combating the child's cells unknown to the mother's body. It will be very difficult to bear a baby, and he may develop:

• anemia;
• jaundice;
• reticulocytosis;
• erythroblastosis;
• dropsy;
• edematous syndrome.

The last two cases can end in the death of the baby. For this reason, it is important to undergo a mother-father compatibility test during conception planning in order to avoid complications.

How is it inherited?

The blood group is of 4 types (first, second, third and fourth) and is inherited by the child from the mother and father, like her Rh factor. To understand why an Rhesus conflict can occur, you should delve a little into genetics. All cells in the human body, with the exception of reproductive cells, have 2 dominant and 2 chromosomes. recessive genes. When an egg is fertilized by a sperm, a new cell is formed with a unique set of chromosomes responsible for the external and internal characteristics of the baby.

The table provides information about the Rh factor of the child, depending on which Rh the father and mother have:

Negative Rh in 100% of cases occurs in babies whose parents are also with negative Rh. With other combinations, the appearance of any Rh factor is likely. The gender of the parent is not important. The process is influenced exclusively dominant gene.

Rhesus conflict occurs if the mother has a negative Rh, and the fetus is positive. Her body is not familiar with the new baby cells. However, the problem occurs in less than half of all cases, since it is required that the blood of the baby and the mother mix, and this does not happen during pregnancy, because. the placenta protects the fetus. A similar phenomenon is observed when:

• miscarriage;
• abortion;
• ectopic pregnancy;
• bleeding throughout the entire period of gestation.

For this reason, during the first pregnancy, this phenomenon is unlikely. The risk increases with repeated conceptions.

Can an Rh-positive father and mother have an Rh-negative child?

Is it possible to give birth to a baby with a negative Rh if mom and dad have it positive? Such a phenomenon is not considered a pathology or deviation and does not indicate the infidelity of the spouse.

Rhesus is transmitted to a child with paternal genes. In a man, a couple of genes are responsible for positive Rh. It appears in two combinations:

1. The first one is D.D. Both genes are dominant. They occur in 45% of Rh positive men. In this case, the baby is always born Rh-positive.
2. The second is Dd. Rhesus heterozygosity allows the transfer of a dominant gene to the fetus in half the cases, which implies that the probability of transmitting a recessive negative gene is 50%. The number of males with the Dd combination is about 55%. About a quarter of Rh-positive men have Rh-negative children. Rhesus conflict, even if the family has different parameters, does not occur.

Can Rh negative parents have a positive child?

The opposite situation, which is often asked by future parents planning to conceive a child. Is it possible for a Rh negative man and woman to have a positive Rh baby? For this, Rh-combinations should be considered. A negative Rh combination is called a combination of dd, i.e. combination of two recessive genes. In other words, neither the father nor the mother has a specific protein in the erythrocytes, and there is nowhere to take such an antigen from the child. That is, he will be the owner of a negative blood Rh.

Doctors were often puzzled by the death of patients after transfusions of seemingly ideally matched donated blood. It turned out that the reason for this was the Rh factor - a special protein, or rather, its absence.

In the blood of 85% of the entire population of the globe, this protein is present, and only 15% of people are deprived of it. The name was derived from the rhesus monkey whose blood was used in the experiments.

Rh factor protein is located on the surface of red blood cells -. It does not affect the state of human health, that is, in principle, both a child with the presence of this protein (with positive indicators) and with its absence (with negative indicators) is born healthy.

Problems can arise only when mixing different types blood.

An organism that has blood with a positive Rh factor, getting blood even of a suitable group, but with a missing protein, is perceived as an alien attack. The activation of immunity begins to fight the "invader", and the so-called arises.

Reasons for the appearance or absence of a special protein in a child

The formation of the Rh factor in a baby is completely controlled by the laws of genetics. If both parents have a positive Rh factor, then a child can be born to them both with the same indicator and without it, that is, with a negative Rh factor. The same condition can appear if the mother has negative blood, and the father has positive blood.

If the fetus inherits the mother's blood, everything will be fine, but the appearance of a positive fetus in a negative mother threatens the development of an Rhesus conflict. If timely measures are not taken, the pregnancy may end in miscarriage, as the mother's body will perceive the fetus as a foreign body. However, if there is knowledge of a possible conflict, this happens extremely rarely, because the blood of the mother and fetus do not normally mix. Only in the presence of various pathologies, the entry of fetal cells into the mother's bloodstream can provoke a negative reaction in which the pregnant woman's body will try to expel the fetus.

Medical techniques make it possible to avoid such complications, to endure and give birth to a normal child.

In most cases, the mixing of the blood of mother and child occurs only at the time of birth and lasts a very short time.So that the baby does not develop hemolytic disease of the newborn, characteristic of the Rhesus conflict, it is immediately placed under special blue lamps.

This prevents the appearance negative impact different blood.In the same case, if both parents are blood-negative, they cannot be born in any way. positive child- in his blood there will simply be nowhere for that very important protein to appear. So both parents with a negative Rhesus cannot become parents of a child positive for the factor. This is contrary to the laws of nature and our knowledge of human genetics.

A negative Rh factor in a child does not mean that he has any defects or developmental disorders. This is absolutely the same child as having positive blood. It's just that in his body there is no tiny component that will have to be taken into account in the process of his life and development.

Norm or pathology

A negative Rh factor in a child is not a pathology, it is a variant of the norm, characteristic of a certain part of the population. With the achievements of modern medicine, women with negative blood become mothers and give birth to healthy children, because the Rh conflict appears in less than half a percent of all cases.

Otherwise, this feature of the blood does not affect the general health of a person in any way - it is absolutely identical to people with a positive Rh, with the exception of a tiny protein.

You can learn more about what a blood type and Rh factor are from the video.