Outcomes of Pregnancy and Labor in Rhesus-Conflict Pregnancy
Abstract
About 15% of women have Rh-negative blood, most of them are planning to have children with Rh positive men. During pregnancy, situations sometimes arise when small portions of fetal blood enter the mother's blood. If the mother also has an Rh antigen (Rh-positive, like the baby), her immune system will not react in any way to such an invasion. If the mother is Rh negative, then the Rh antigen on the child's erythrocytes is a foreign agent for her. In this case, the mother's immune system reacts in a special way - her body begins to produce antibodies that recognize the Rh antigen and destroy the red blood cells on which it is attached. These antibodies act not only inside the mother's body, through the placenta they penetrate into the circulatory system of the fetus and destroy its erythrocytes. This pathological condition is called Rh-conflict. In order to study the characteristics of the course of pregnancy and childbirth, as well as perinatal outcomes in patients with Rh-conflict pregnancies, a retrospective analysis of 30 birth histories of patients with Rh-sensitization was carried out. It was revealed that the most important risk factor for the development of Rh immunization is the lack of timely specific prophylaxis through the introduction of anti-Rh-immunoglobulin. Prognostically unfavorable in relation to the development of severe forms of Hemolytic disease of the newborn is the early (up to 20 weeks) detection of a high titer of antibodies (1:16 or more) and its increase during pregnancy, as well as the growing and "jumping" nature of the dynamics of the titer of Rh antibodies. The most informative method for diagnosing the severity of Hemolytic disease of the newborn is Doppler blood flow in the fetal middle cerebral artery, which makes it possible to resolve the issue of timely intrauterine blood transfusion of the fetus.
References
2. Schumacher B., Moise Jr. K. J. Fetal transfusion for red blood cell alloimmunization in pregnancy // Obstetrics & Gynecology. 1996. V. 88. №1. P. 137-150. https://doi.org/10.1016/0029- 7844(96)00113-5.
3. Hadley A. G. et al. Correlation of serological, quantitative and cell‐mediated functional assays of maternal alloantibodies with the severity of haemolytic disease of the newborn // British journal of haematology. 1991. V. 77. №2. P. 221-228. https://doi.org/10.1111/j.1365- 2141. 1991.tb07981.x
4. Konoplyannikov, A. G. (2008). Modern aspects of pathogenetic mechanisms of the fetus and newborn hemolytic disease. Bulletin of Russian State Medical University, (6), 38-42.
5. Ailamazyan, E. K., & Pavlova, N. G. (2012). Izoimmunizatsiya pri beremennosti. N-L., 164.
6. Mamedalieva, N. M., Sharipbaeva, N. T., Daniyarov, N. N., & Dzhidzhilava, G. M. (2015). Akusherskie i perinatal'nye iskhody rezus-konfliktnoi beremennosti. Vestnik KazNMU, (2), 18-21.
7. Vetrov, V. V., & Ivanov, D. O. (2016). The aethiopathogenesis of haemolytic desease fetus and newborn by rhesus-conflict. Problems of women’s health, 11(4), 52-60.
8. Pavlova, N. G., Shelaeva, E. V., & Nagornneva, S. V. (2013). Pathogenetic approach to the pregnancy management in severe alloimmunization. Journal of obstetrics and women’s diseases, 62(3), 58-62. https://doi.org/10.17816/JOWD62358-64.
9. Collins C.Y.,Ott W.J. Evaluating suspected featal anemia with Doppler ultrasound //J. Reprod.Med.-2005, Jun. -Vol.50. - N6. - P.379-382.
10. Liao C., Wei J.,Li Q.et al Efficacy and safety of cordocentesis for prenatal diagnosis // Int.J. Gynaecol. Obstet. -2006, Apr. - vol.93. - N1. - P.13-17
