Conflict RH

The doctor informed you, that the blood test showed, that you have the Rh group. What does this mean for my baby? Means, that there are makings of trouble fortunately these troubles are easily preventable. A little knowledge of biology will help you understand, how. Every cell in the body has numerous antigens on its surface, or structures resembling "antennas". One of these antigens is the Rh factor. We all inherit blood cells, which either have this factor (then the person is Rh +), or not (then we are talking about Rh-). If a pregnant woman does not have Rh factor (that is, it is Rh negative), and her fetus is maturing (that is, is positive Rh), the immune system of the mother's body will take care of the fetus (and its Rh positive blood cells) for "stranger". As part of the response, the woman's system will send armies of antibodies to attack the intruder. This phenomenon is called the Rh-conflict.

All women in the early stages of pregnancy are tested for the presence of the Rh factor, usually during the first visit. If it turns out, that the expectant mother is Rh positive, and so is u 85% women, the matter of compatibility becomes irrelevant, because regardless, whether the fetus will have Rh + or Rh- factor, there are no foreign antigens in the baby's blood cells, that could mobilize the mother's immune system.
However, when the mother, just like you, has rhesus factor, the father of the child is also examined, to check, whether he is rhesus positive or negative. If it turned out, that your husband is Rh-, your child will have the same (because two "negative" parents cannot have a "positive" child), and that means, that your body will not perceive it as "foreign". However, if your husband had Rh + factor, then there would be a probability, that the fetus will inherit this factor from him, as a result, a conflict will arise between you.

This discrepancy usually does not even foreshadow problems during the first pregnancy. Only then does the trouble begin, when some of the baby's blood enters the mother's bloodstream during the first birth (or miscarriage). The mother's body then produces antibodies against the Rh factor as part of its natural defense process. The antibodies themselves are harmless – until the woman becomes pregnant again and carries another Rh + baby. During the next pregnancy, new antibodies can cross the placenta into the fetal bloodstream and attack the baby's red blood cells, causing him to be insignificant (if the maternal antibody level is low) or serious (if their level is high) anemia. Only in very rare cases do such antibodies develop during the first pregnancy, and it is so, if the baby's blood passes across the placenta into the mother's bloodstream.

Prevention of the formation of Rh antibodies is the main way to protect the fetus in the event of an Rh conflict. Most doctors use dual therapy. W 28 one week of pregnancy in the Rh group- Rh immunoglobulin is given by injection, called Rhogam, to prevent the formation of antibodies. A repeated dose is administered over the course 72 hours after giving birth, if the blood test shows, that the newborn has the Rh + group. If the child is Rh-, no treatment is necessary. Rhogam is also given after a miscarriage, ectopic pregnancy, abortion, chorionic villus sampling, amniocentesis, uterine bleeding or injury during pregnancy. Applying the right dose of Rhogam in these cases may anticipate more serious complications in the course of a future pregnancy..

If the Rh- she did not receive Rhogam during her previous pregnancy, and research would show, that her body developed antibodies capable of attacking the fetus with the blood group Rh +, then the blood type of the fetus can be checked by cordocentesis. If he is Rh-, then the mother, and the baby have compatible blood types and there is no need for concern or treatment. But if it had the Rh + factor, there would be a conflict with the mother's blood type, therefore, maternal antibody levels would need to be kept under constant control. In case this level becomes alarmingly high, studies would be carried out to evaluate, the condition of the fetus. If at any time the safety of the fetus is compromised due to haemolytic disease or Rh conflict, you may need a blood transfusion with the Rh group. If the conflict was of a serious nature - which is rare – transfusion is performed before delivery. More often, however, this can be waited until birth and done immediately after delivery. In mild cases, when the antibody level is low, a transfusion may not be necessary. Nevertheless, if necessary, doctors will be prepared to perform it shortly after giving birth.

The use of Rhogam has greatly reduced the need for transfusions in the case of, while there was an Rh conflict during pregnancy, to less than 1 %, and in the future, this life-saving procedure may be just a medical miracle from the past. A similar conflict can occur because of another factor in the blood, Kell antigen (another "antence" found in blood cells), however, it occurs much less frequently than the Rh conflict. If the father has these antibodies, and the mother did not, this may portend problems. During standard research, part of your first routine blood test, it works, Whether there are anti-Kell antibodies circulating in the mother's blood. If they are detected, the father's blood is tested, to check, whether she is Kell-positive. If that's so. continues as for rhesus conflict.