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In today`s obstetrics and gynecology a problem a Rhesus factor - the conflict is considered solved. The mechanism of this phenomenon is known, methods of prevention and treatment are developed. Why, apparently, to touch upon this subject in the popular magazine - all needing the help it is necessary just to see a doctor.

But in that is continually that our readers living in Moscow, the Moscow region, Yekaterinburg, Tyumen and Khabarovsk Krai, did not obtain the necessary help and information. Therefore their questions relatively a Rhesus factor - incompatible pregnancy we asked to comment on the immunologist of the Center of planning of a family and a reproduction of the person, the candidate of medical sciences Tatyana Viktorovna Alekseeva.

At the husband the 2nd positive blood type, at me - 1 negative. Whether the Rhesus factor - the conflict threatens our future child?

K the Rhesus factor - to the conflict gives incompatibility of blood of mother and a fruit on a Rhesus factor - to a factor. The Rhesus factor - a factor (or a Rhesus factor - an anti-gene) is a substance which is on a surface of red blood cages (erythrocytes) and serves as an identification mark for immune system. The people having a Rhesus factor - an anti-gene, a Rhesus factor - are positive, not having it - a Rhesus factor - are negative.

the Rhesus factor - the conflict during pregnancy can arise, only if mother a Rhesus factor - is negative, the father - a Rhesus factor - is positive (as in the described case), and the kid inherited a positive Rhesus factor - an anti-gene from the father.

As the Rhesus factor - the conflict occurs? If during pregnancy fruit erythrocytes through a placenta get to mother`s blood, then her immune system destroys them by means of antibodies as “alien“.

But sometimes at mother do not find a Rhesus factor - antibodies even if the child a Rhesus factor - is positive. Obviously, good matochno - the placentary barrier does not pass fruit erythrocytes in mother`s blood. it is important to p to know

that at any manipulations on a uterus fruit blood inevitably gets into blood of mother which immune system can begin to develop antibodies. Therefore if at a Rhesus factor - the negative woman there were childbirth, abortions, abortions or a scraping, her organism can be sensibilizirovan - that is some quantity a Rhesus factor - antibodies is already made. If it is your case, it makes sense even before conception to make the corresponding blood test that proceeding from its results to choose further tactics of planning and conducting pregnancy.

If pregnancy really the first and the above described episodes did not happen to

, it is regularly necessary to check blood for a Rhesus factor - antibodies - according to the plan, planned by the doctor observing you. It will allow to understand in time whether the Rhesus factor - the conflict threatens your future child, and to take measures.

Heard

that the Rhesus factor - the conflict can lead to a hemolytic illness at the child. What is it?

If the maternal antibodies developed in response to hit in a blood-groove of mother of erythrocytes of a fruit break through a placenta barrier, they begin to destroy fruit erythrocytes already in its own vessels. So the hemolytic illness begins. At the same time there is a bilirubin - the fabric poison worsening tissue respiration capable to injure a fruit brain, to lead to a hearing disorder, the speech, but also, painting skin of the kid in yellow color (“jaundice“). At the kid the liver and a spleen increase, there are hypostases of internals and fabrics, oxygen starvation, congenital dropsy develops. He can die.

a hemolytic illness is successfully diagnosed Today vnutriutrobno, in particular, on the basis of ultrasonic research which shows increase in a liver of a fruit, a placenta thickening, abundance of water. Helps to make the diagnosis kordotsentez at which the level of bilirubin and hemoglobin in the blood taken from an umbilical cord is defined. Allows to judge the level of bilirubin also an intake of amniotic waters - amniotsentez.

the Hemolytic illness is treated by

at the first and second stages when its main manifestations are anemia and jaundice and provided that the level of bilirubin is not high. The main method of treatment - zamenny pre-natal transfusion a Rhesus factor - negative blood to the child under ultrasonography control. The Anemichesky stage of an illness sometimes manages to be corrected by means of vitamin therapy.

the Last stage is almost incurable

as hypostases affect all fabrics, internals and a brain of a fruit. Newborns with such form of a hemolytic illness usually premature therefore the risk of their death is big.

during the first pregnancy of antibodies in blood it was not found p. At least, two more times would like to become mother. As far as it is real? And in general to how many children the woman about a Rhesus factor - incompatibility can give birth, without risking their health? With what frequency it is better to give birth?

of the Definite answer to the first two questions does not exist because it is impossible to predict, a Rhesus factor - the factor of which of parents will be inherited by their next child. So, some women gave birth to 5 children or made 5 abortions, but a Rhesus factor - antibodies were not found in them. Unfortunately, we are not able to predict yet precisely in what case at a Rhesus factor - the negative woman, the pregnant woman a Rhesus factor - a positive fruit, development the Rhesus factor - antibodies will take place and in what - no.

only the general regularities Are known to

. At the first pregnancy level the Rhesus factor - antibodies if they appear, is usually not too high: the immune system of mother for the first time faces “alien“ cages. In the subsequent pregnancies, thanks to “cellular memory“, the immune system of mother develops antibodies more quickly and in bigger quantity. For this reason a Rhesus factor - to negative women recommend to avoid interruption of the first pregnancy.

One more rule: if the organism of mother is sensibilized, then once and for all, it will not be possible to get rid from a Rhesus factor - antibodies any more.

Therefore frequency of childbirth does not play a large role: if antibodies already are, in intervals between childbirth their quantity will not change; and if they are absent - means, no. The only thing governed - it is necessary to approach the birth of each next child responsibly and to try to exclude whenever possible possible complications of pregnancy.

The matter is that to provoke development a Rhesus factor - antibodies at a Rhesus factor - incompatible pregnancy an otsloyka of a placenta and any other violation of its integrity as a result of a gestoz or infectious diseases, a trauma at the pregnant woman, such researches as amniotsentez and a biopsy of a horion, - in all these cases fruit erythrocytes can get into blood of mother too can and cause the reply of her immune system.

the Probability of a sensitization depends also on with what the previous pregnancy ended. After an abortion a Rhesus factor - antibodies arise in 3 - 4% of cases, after abortion - in 5 - 6%, after extra-uterine pregnancy - in 1% of cases, after the delivery - in 10 - 15%. Increases risk of a sensitization and Cesarean section.

to

In literature which I managed to find on this subject it is written that a Rhesus factor - have to do to the negative woman after each childbirth or abortion vaccination antirezuz scale - globulin. Only then her subsequent children are protected from consequences a Rhesus factor - the conflict. But neither me, nor my familiar with a negative Rhesus factor such inoculations did not do. Answered my questions:“ And why you need it? Gave rise normally - and all“. And what`s next? I am going to have not one child. How to be if during the following pregnancy of an antibody in blood all - find?

you are right

: antirezusny scale - globulin which connects antibodies at the time of their development the woman needs to enter after any manipulations on a uterus (all of them are listed in my previous answers). The injection of this preparation which is made at city stations of blood transfusion reliably protects from a Rhesus factor - the conflict in the subsequent pregnancies. But it is necessary to do it within 72 hours, it does not make sense later: if antibodies already appeared (or were present at blood and before pregnancy), the scale - globulins will not be possible “to connect“ them, and in this case injections are useless.

Unfortunately, as far as I know, such injections do not do

almost anywhere, even in Moscow, except for maternity hospital at the Center of planning of a family and reproduction (on Sevastopolsky Avenue). I know that some women concerned by a problem a Rhesus factor - the conflict, buy anti-D - immunoglobulin, and at their request in maternity hospital do them an injection.

If antibodies in blood are found by

during pregnancy, on early terms do to a fruit blood transfusion with a negative Rhesus factor. On late terms - stimulate childbirth, and then treat the kid.

by

at me gave birth Six years ago the daughter, after that there were three more pregnancies which ended with an abortion on early terms. It can be connected with the fact that I have a negative Rhesus factor? Whether it will manage to me to give birth still to the child?

the analysis on a Rhesus factor - antibodies will help to Give to

the answer to this question, it is done in any policlinic. If to find them, it is not excluded that they became the abortion reason. Depending on quantity of antibodies in blood the doctor can suggest to lower their level by means of a plasma exchange: at this procedure physiological solution is entered into part of the plasma taken from the woman. But it is necessary to do it even before pregnancy.

However not only the Rhesus factor - the conflict can lead

to an abortion. Therefore I advise you to pass full inspection: to find out whether there are no gynecologic infections (clamidiosis, a virus of simple herpes, a cytomegalovirus, etc.), to look at a hormonal profile as hormonal insufficiency of ovaries or the increased content of male sex hormones can cause an abortion. It is useful to make the test and for antibodies to the husband`s sperm. I will add that all these researches are included into the program of treatment both infertility, and pregnancy not incubation today.