Rhesus factor (D-antigen) is a protein located on the surface of red blood cells. 10-15% of the world’s population lacks this protein, they are considered Rh-negative.
When a woman is Rh-negative and her husband is Rh-positive and the child inherits her father’s Rh, antibodies to the antigen D are produced in the pregnant woman’s body.
During the first pregnancy, a woman’s body produces immunoglobulins M (antibodies), which do not cross the placenta and do not have a harmful effect on the fetus. This is called Rhesus sensitization. This can happen with miscarriages, blood transfusions. With repeated pregnancy, immunoglobulins G are produced, which penetrate the placenta and have a harmful effect on the fetus and lead to the development of hemolytic disease of the fetus.
Once the mother’s antibodies enter the fetal body, they react with resuspension erythrocytes of the fetus and destroy the red blood cells of the fetus, causing hemolysis. The fetus develops hemolytic anemia.
In addition, the liver and spleen, being hematopoietic organs, begin to intensively produce new red blood cells and increase in size (hepatosplenomegaly). In severe cases, when the liver and spleen can not cope, fetal death occurs.
The following forms of hemolytic disease of the fetus are distinguished
To avoid the appearance of antibodies in a mother with Rh-negative blood in the first pregnancy, when there is still no sensitization of the body (there are no antibodies to the Rh factor in the mother’s blood), a woman should introduce anti-Rhesus gammaglobulin D.
And after the birth of the first child, if the Rh positive affiliation is found in the baby, inject the mother again within 72 hours after birth the second dose of the anti-Rhesus immunoglobulin D. This will avoid the Rh conflict in subsequent pregnancies.
The introduction of a rhesus-negative woman anti-rhesus gammaglobulin D is recommended after miscarriages, abortions, obstetric procedures, blood transfusions.
Pregnancy management in women who already have sensitization of the body is reduced to constant determination of the level of antibodies during pregnancy, conducting fetal ultrasound dynamics, dopplerometry, and, if necessary, conducting amniocentesis to determine the level of bilirubin in the amniotic fluid. Conducting in the specialized perinatal centers intrauterine replacement perilatus of the blood of the fetus.
And timely delivery of the fetus, while the condition has not worsened