Antibodies in pregnancy: how dangerous Rh-conflict and group incompatibility

Often, women who have a negative Rh factor are worried about their pregnancy and, I must say, is not unfounded. Rhesus factor is a protein found on the surface of red blood cells. Complexities arise if the mother has a negative Rh factor (Rh-), and the child (Rh +) has a positive, inherited from the father. Less often incompatibility develops on system ABO (group incompatibility). When the fetal antigen hits the mother's blood, antibodies are produced.

Antibodies during pregnancy destroy the red blood cells of the fetus, which leads to negative consequences, such as hemolytic disease. Concomitant problems are: a violation of the liver, the work of the circulatory system, heart failure. In the fetus, fluid can accumulate, leading to edema. The disease begins to develop already from the 22nd week of pregnancy.

Why Rhesus is dangerous?

It should be noted that Rh-conflict is not very dangerous in case pregnancy is the first. Mixing maternal blood with a child's blood occurs after birth, and even the already formed antibodies do not pose a threat to the baby.

However, if a woman is waiting for a second baby, antibodies during pregnancy can cause serious pathologies, from which the child can die in the womb. The main danger is the allocation of a large amount of bilirubin in the fetus to fight the antibodies, which can adversely affect its internal organs, mainly the liver, spleen and brain. Often, Rhesus-conflict leads to miscarriage or premature birth.

Antibodies during pregnancy are formed if the woman has a Rh factor negative, and the man has a positive rhesus. In this case, Rh-conflict occurs in 75% of cases. Incompatibility may occur if a woman has received a blood transfusion, and Rhesus was not counted.

Blood test for antibodies

Even during pregnancy planning, every woman should know her Rh factor and Rh factor of the child's father. If there is a chance of a rhesus-conflict, then it will be necessary to do an analysis of the antibodies during pregnancy repeatedly. The first time you need to make this procedure at 8 weeks of pregnancy and then regularly check for antibodies until 30 weeks - once a month, until 36 weeks - weekly.

To the same serious consequences leads incompatibility of blood groups of mother and child. Difficulties arise if the woman has I blood group, and the fetus has blood of II or III group. In this case, fetal antigens enter the mother's blood and group antibodies are released. Group antibodies in pregnancy lead to the development of hemolytic disease and are no less dangerous than D-antigens.

However, a blood test for antibodies can indicate a pathology only if it was performed in combination with other diagnostic methods. Of great importance is the antibody titer and its change in the course of pregnancy. The higher the antibody titer, the more likely the adverse outcome is.

Antibodies in pregnancy should be detected in a timely manner, and the woman in the position is prescribed injection courses, which are conducted from 10 to 22, from 22 to 24 and from 32 to 34 weeks. In case of complications, the pregnant woman should be in the hospital, under the supervision of doctors.

Women with a history of miscarriages or a born child with severe hemolytic disease undergo a procedure called plasmapheresis, which is aimed at removing antibodies from the blood.

If the hemolytic disease of the fetus is confirmed, it is correct to premature delivery. This is due to the fact that by the end of the period, the intake of antibodies to it is increasing. In severe fetal disease, pregnancy is interrupted. But in most cases it can be brought to an acceptable delivery date.