Rh negative parents. Rh - negative pregnancy - what is the conflict

When does a pregnant woman usually first think about such a concept as "Rhesus conflict"? Usually when she finds out she has Rh negative blood. And questions arise: what is it and is it possible to avoid Rh-conflict during pregnancy?

These questions are answered by Maria Kudelina, a doctor, Rh-negative mother of three children.

What is Rh conflict during pregnancy?

Rhesus conflict is possible during pregnancy. This is a conflict between the mother's immune system and the child's blood, when the mother's immune system begins to destroy the elements of the child's blood (erythrocytes). This happens because there is something on the baby's red blood cells that is not on the mother's red blood cells, namely the Rh factor. And then the mother's immune system perceives the child's red blood cells as something alien, like bacteria and viruses, and begins to destroy them. This can happen when the mother is Rh-negative and the baby is Rh-positive.

According to statistics, approximately 15% of people are Rh-negative, and 85% are Rh-positive. Rh conflict is possible during pregnancy when the mother is Rh-negative and the child is Rh-positive. If a Both parents are Rh negative, then the child will also be Rh negative and the conflict is excluded. If the father is Rh-positive, with an Rh-negative mother, the child can be both Rh-negative and Rh-positive.

When does Rh conflict occur during pregnancy?

Suppose the mother is Rh negative and the child is Rh positive. Is it necessary to have an Rhesus conflict during pregnancy? No. For a conflict to occur, it is necessary that Rh-positive blood entered the blood of an Rh-negative mother. Normally, this does not happen during pregnancy, the placenta does not allow blood cells to pass through.

In what situations is this possible?

Rh-incompatible blood of a child can get into the Rh-negative blood of the mother in the following cases:

during a miscarriage,
medical abortion,
ectopic pregnancy,
if a woman has bleeding during pregnancy.

A conflict is also possible if mothers have ever had Rh-positive blood transfusions before. It is also possible for the baby's blood to reach the mother during normal births.

Thus, during first successful pregnancy, the risk of Rh conflict is very small. A tangible risk occurs with repeated pregnancies.

Rh immunoglobulin - how it works

Modern medicine has the ability prevent rhesus conflict when Rh positive blood enters the mother's blood. Most often, Rh conflict can be prevented by injecting anti-Rh immunoglobulin (Rho D immunoglobulin) into an Rh-negative mother. within 72 hours of exposure to Rh-positive blood before the mother's own antibodies have developed.

This usually happens after childbirth if anti-Rhesus antibodies were not detected in the mother's blood during pregnancy. You can not give an injection if, according to the result of a blood test of a child, it turns out that he also has a negative Rh.

With the introduction of synthetic immunoglobulin, the erythrocytes of the Rh-positive fetus that enter the mother's body are destroyed before her own immune system has time to respond to them. Mom own antibodies to the child's erythrocytes are not formed. Synthetic antibodies in the mother's blood are usually destroyed within 4-6 weeks after injection. And by the next pregnancy, the mother's blood is free of antibodies and is not dangerous for the baby. While own maternal antibodies, if formed, remain for life and can lead to problems in subsequent pregnancies.

Prevention of Rh conflict is carried out by the attending physician, taking into account the individual characteristics of each case.

What to do for Rh-negative women during pregnancy

During pregnancy in an Rh negative woman blood tests every month for the presence of anti-Rhesus antibodies in her blood. If anti-Rhesus antibodies appear in the blood of a pregnant woman, this indicates that the blood of a Rh-positive child has entered the mother's blood and a Rh conflict is possible. In these cases, the doctor's observation of the course of pregnancy and the condition of the child becomes more thorough, you need to regularly do blood tests to measure the level of antibodies (antibody titer in Rh conflict). If a anti-rhesus antibodies are not detected during pregnancy, this means that everything is fine, there is no Rh conflict and nothing more needs to be done before the birth.

What to do after childbirth

Ideally, after childbirth, the child will be taken as soon as possible blood analysis and determine the blood type and Rh factor. In Russian maternity hospitals, blood is most often taken from a child from a vein. If the baby turns out to be Rh negative, the mother can be very happy and she does not need to inject anything in this case.

If a the child is Rh positive, and the mother did not have anti-Rhesus antibodies during pregnancy - to prevent a possible Rh conflict during the next pregnancy, an intramuscular injection is made with anti-rhesus immunoglobulin within the next three days until my mother's immune system has had time to start producing its own antibodies. This drug can be bought as prescribed by a doctor in a pharmacy after childbirth, if it is not in the hospital. Ask relatives to help you and control this important issue for you, if necessary. remembering your Rh factor your doctor in the maternity hospital.

If the antibodies in the mother's blood have managed to develop, then thanks to the immune memory they will remain for life. What does it threaten? In subsequent pregnancy increases the likelihood of Rhesus conflict- hemolytic disorder, which can lead to various consequences: from neonatal jaundice and the need for blood transfusions to miscarriages, premature births and stillbirths. Fortunately, there are modern methods of treatment. But still Rhesus conflict is easier to prevent than to treat.

Rhesus conflict and breastfeeding

In cases where there is definitely no Rh conflict (mother and child with the same Rh-negative blood or the child is Rh positive, but no signs of Rh conflict were detected during pregnancy), breastfeeding is no different.

Jaundice after childbirth is not a mandatory sign of conflict, so you should not focus on it. Physiological jaundice appears in a newborn not because of a Rh conflict or breastfeeding, but as a result of replacing fetal hemoglobin with a normal human one. Fetal hemoglobin is destroyed and gives yellowness to the skin. This is a normal physiological situation, usually not requiring intervention.

If the Rhesus conflict nevertheless arose, then modern medicine has enough ways to help the child. Even diagnosis of hemolytic disease is not a contraindication to breastfeeding. These children need more frequent and prolonged breastfeeding.

Prohibition of breastfeeding in case of hemolytic disease, as a rule, is associated with the fear that the antibodies contained in milk will exacerbate the situation. However, under the influence of the aggressive environment of the stomach, the antibodies that got into the milk are destroyed almost immediately. Based on the condition of the child, the doctor determines the possibility and method of breastfeeding: whether it will be sucking from the breast or feeding with expressed milk. And only if the child's condition is severe, he can receive nutrition in the form of solutions injected into the vein.

There may or may not be a conflict.

For women with Rh-negative blood, it is especially important that the first pregnancy proceeds safely and ends with a successful birth. Should be done after childbirth a child's blood test for group and rhesus. And if the child is with Rh-positive blood, and antibodies were not found in the mother, anti-Rhesus immunoglobulin is administered to her over the next three days. With the second and subsequent pregnancies, it is also necessary to control the absence of antibodies in the mother's blood.

Be careful and everything will be fine!

What blood type will the future baby inherit? - this question worries a lot of couples who are "waiting for a miracle." To find out, we will tell you what the blood type and Rh factor are, and whether it is possible to predict in advance what they will be like in a child.

What is blood?

Blood is nothing more than a liquid tissue that circulates inside the human body and maintains a proper metabolism.

It consists of:

liquid part, i.e. plasma and cellular elements;
erythrocytes and leukocytes;
platelets;
gas (nitrogen, oxygen and carbon dioxide);
from organic substances, which include proteins, carbohydrates, fats and nitrogenous compounds.

What are the blood types?

Blood type is nothing more than a difference in the structure of proteins. As an indicator, it cannot change under any circumstances. Therefore, the blood group can be considered a constant value.

It was discovered by the scientist Karl Landsteiner at the dawn of the 19th century, who stood at the origins of the definition of the ABO system.

According to this system, blood is divided into 4 known groups:

I (0) - a group in which there are no antigens A and B (molecules involved in the formation of immunological memory);
II (A) - blood with antigen A in the composition;
III (B) - blood with antigen B;
IV (AB) - this group contains two antigens at once, A and B.

The unique ABO system (blood group) changed the scientists' understanding of the composition and nature of blood and, most importantly, helped to avoid transfusion errors that occurred as a result of the incompatibility of the patient's blood with the donor's.

Rh factor - what is it?

The Rh factor is a protein antigen found on the surface of red blood cells. Scientists first discovered it back in 1919 in monkeys and a little later confirmed the existence of the Rh factor in humans.

The Rh factor includes more than 40 antigens, which are indicated by numbers and letters. The most common Rh antigens found in nature are D (85%), C (70%), E (30%) and E (80%).

According to statistics, 85% of Europeans become carriers of a positive Rh factor, and the remaining 15% - a negative one.

Rh mixing

Surely you have heard that when mixing the blood of parents with a different Rh factor, a conflict often occurs. This happens if the mother carries a negative Rh in herself, and the father is positive. The health of the child in this case depends primarily on whose Rh is “stronger”.

If the future baby decides to inherit the father's blood, then the mother's blood will “increase” the content of Rh antibodies every day. The problem is that, penetrating inside the fetus, they will destroy red blood cells, then the body itself, which, as a result, can lead to hemolytic disease of the crumbs.

What are Mendel's laws?

The laws of Gregor Mendel, an Austrian biologist, which geneticists and physicians rely on, are nothing more than a clear description of the principles for the transmission of certain traits by inheritance.

They served as a solid basis for the subsequent emergence of the science of genetics, and it is on them that one should rely when predicting a child's blood type.

Principles of inheritance of blood groups according to Mendel

According to the laws of Gregor Mendel, if parents have 1 blood type, they will have children without antigens A and B.
If the parents of the unborn baby have blood types 1 and 2, then the children will inherit them. The same applies to groups 1 and 3.
4 blood type is a chance to conceive children with 2, 3 or 4 group, excluding the first.
A child's blood type is not predicted in advance if his parents are carriers of groups 2 and 3.

The exception to these rules, which have not changed over the years, has become the “Bombay phenomenon”. We are talking about people whose phenotype contains A and B antigens, but for some reason they do not manifest themselves in any way. This situation is very rare and most often among the Indians.

How is the Rh factor inherited?

The Rh factor is denoted by the letters Rh. Being positive, it carries the prefix "plus", and negative - the sign "minus".

It is possible to assume its type with an accuracy of 100% only if the Rh of both parents is negative, in all other cases the Rh will be different.

Inheritance system

The positive Rh factor, which is determined by the D gene, has different alleles in its structure: dominant (D) and recessive (d). In other words, a person with Rh (+) type can carry both the DD genotype and Dd. A person with Rh (-) Rh is a dd carrier.

Knowing this inheritance pattern, it is quite possible to predict the future Rh factor in a child who has not yet been born. If the mother is negative with the dd genotype, and the father is positive (DD or Dd), then the baby can inherit any of the possible options. This is clearly demonstrated by the following table:

Thus, if the father has a DD type in himself, the couple's offspring will receive Rh-positive Rh, and if he has a Dd type, then this probability is reduced to 50%.

What else can a baby inherit?

Of course, parents are not only concerned about what type of blood their child will have. They are also wildly interested in whether the baby will inherit, for example, their eye or hair color.

Dominants and recessives

Such intriguing questions are answered by genetics, and this is done thanks to her knowledge of two types of genes: dominant and recessive. The former always outstrip the latter and suppress them.

Overwhelming, dominant features include such appearance traits as blood type, freckles or dark skin, dimples, fluffy eyelashes, hump on the nose, myopia or early graying.

So, for example, with brown eyes of the father and blue mother, the little one will be dark-eyed.

traits that are inherited

By inheritance can be transmitted:

blood type and Rh factor (as we found out earlier);
color of the skin;
features of vision (nearsightedness or strabismus and other defects);
growth (low or high);
individual structural features of the arms and legs;
auditory characteristics (ear of music, normal or deafness);
facial features (including freckles and dimples);
the shape of the mouth, nose and ears;
hair color;
diseases (for example, diabetes mellitus and hemophilia).

But the character of the baby on these grounds is quite difficult to predict. If only to try to determine the psychotype of the personality to which the child will belong.

But what about IQ?

Of course, a child can take not only the blood type and external signs from his parents. However, the IQ value, which future moms and dads often worry about, does not depend much on heredity.

Oddly enough, for the development of the intellect and brain of a child, a favorable family environment and early communication are much more beneficial than heredity.

At the same time, according to experts, women who constantly engaged in physical education during pregnancy can give birth to a gifted child. It also stimulates mental activity in a child and breastfeeding (increases IQ by 6 units).

A matter of health

As for diseases, everything here has long been known that, unfortunately, along with the color of eyes and hair from parents, a bunch of all kinds of diseases can be transmitted to us, including allergies, schizophrenia, and even mental retardation.

But there is good news: today a person can get their own individual genetic passport in their hands in order to find out about the dangers that threaten them. You can get it by contacting a medical laboratory that deals with DNA analysis and genetic research (and not just such standard tests as blood type and Rh factor).

Having made such an analysis, you will receive a personal “decoding” of the characteristics of the body, which will indicate the tendency to certain diseases, attitude to sports, a list of undesirable foods for consumption, and even a list of climatic conditions that are unfavorable for living.

Children are inherited not only similar to the parental appearance and figure. They receive a whole genetic set of father and mother, the same applies to such phenomena as the development and functioning of the body, all kinds of hereditary diseases of systems and organs, even the smallest details (for example, the structure of hair and nails). Blood and its parameters are no exception. Many nuances are associated with the Rh factor of blood during conception and further pregnancy.

What is the Rh factor?

The blood type and Rh factor (Rh) in humans are unchanged throughout life. These characteristics, which are inherited, are laid down during pregnancy. Rhesus is formed already at 7-8 weeks after conception. Not every pregnant woman knows exactly what effect a parameter can have on bearing a child and on the ability to become pregnant.

First you need to understand what the Rh factor means. It refers to a protein that is localized in red blood cells. Its presence makes the Rh factor positive, the absence - negative. This parameter does not affect the life of a person or his health.

Problems arise when a woman and a man are planning to conceive, because of the risk of conflicting Rh factors. Different Rh factors are rare, because. 85% of people have protein in the blood, and only the remaining 15% are born with a negative indicator.

The parameter got its name in honor of a macaque named "Rhesus", which took part in research experiments. To designate it, it is customary to use the Latin letter D. If it is positive, they put the capital letter D (it is dominant), negative - d (denotes a recessive gene).

positive and negative

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The combination of existing Rh factors gives the child one of the options, positive or negative. There are 3 possible combinations:

It would seem that a positive Rh factor, connecting with a negative one, suppresses it, being a dominant gene, and the baby should be with a positive parameter. This does not happen in all cases of such a combination. The result of different Rh factors in parents periodically becomes a negative gene in a newborn baby. Sometimes, even if both have positive blood characteristics, a child can be born with a negative gene. There is no need to accuse your spouse of treason, because this is quite normal.
The main danger in the mismatch of Rh factors in mother and father is due to the development of Rh conflict during pregnancy. This is fraught with serious consequences. The protein in the baby's blood is perceived by the mother's body with a negative Rh as a foreign element, which provokes the production of antibodies, the action of which is aimed at combating the child's cells unknown to the mother's body. It will be very difficult to bear a baby, and he may develop:
anemia;
jaundice;
reticulocytosis;
erythroblastosis;
dropsy;
edematous syndrome.

The last two cases can end in the death of the baby. For this reason, it is important to undergo a mother-father compatibility test during conception planning in order to avoid complications.
How is it inherited?
The blood group is of 4 types (first, second, third and fourth) and is inherited by the child from the mother and father, like her Rh factor. To understand why an Rhesus conflict can occur, you should delve a little into genetics. All cells in the human body, with the exception of reproductive cells, have 2 chromosomes of dominant and recessive genes. When an egg is fertilized by a sperm, a new cell is formed with a unique set of chromosomes responsible for the external and internal characteristics of the baby.
The table provides information about the Rh factor of the child, depending on which Rh the father and mother have:
Father mother DD Dd dd
DD + + +
Dd + +/- +/-
dd + +/- -
Negative Rh in 100% of cases occurs in babies whose parents are also with negative Rh. With other combinations, the appearance of any Rh factor is likely. The gender of the parent is not important. The process is influenced exclusively by the dominant gene.
Rhesus conflict occurs if the mother has a negative Rh, and the fetus is positive. Her body is not familiar with the new baby cells. However, the problem occurs in less than half of all cases, since it is required that the blood of the baby and the mother mix, and this does not happen during pregnancy, because. the placenta protects the fetus. A similar phenomenon is observed when:
miscarriage;
abortion;
ectopic pregnancy;
bleeding throughout the entire period of gestation.

For this reason, during the first pregnancy, this phenomenon is unlikely. The risk increases with repeated conceptions.
Can an Rh-positive father and mother have an Rh-negative child?
Is it possible to give birth to a baby with a negative Rh if mom and dad have it positive? Such a phenomenon is not considered a pathology or deviation and does not indicate the infidelity of the spouse.

Rhesus is transmitted to a child with paternal genes. In a man, a couple of genes are responsible for positive Rh. It appears in two combinations:
The first is DD. Both genes are dominant. They occur in 45% of Rh positive men. In this case, the baby is always born Rh-positive.
The second is Dd. Rhesus heterozygosity allows the transfer of a dominant gene to the fetus in half the cases, which implies that the probability of transmitting a recessive negative gene is 50%. The number of males with the Dd combination is about 55%. About a quarter of Rh-positive men have Rh-negative children. Rhesus conflict, even if the family has different parameters, does not occur.

Can Rh negative parents have a positive child?
The opposite situation, which is often asked by future parents planning to conceive a child. Is it possible for a Rh negative man and woman to have a positive Rh baby? For this, Rh-combinations should be considered. A negative Rh combination is called a combination of dd, i.e. combination of two recessive genes. In other words, neither the father nor the mother has a specific protein in the erythrocytes, and there is nowhere to take such an antigen from the child. That is, he will be the owner of a negative blood Rh.

Perhaps, in anticipation of the birth of a baby, the question of how the Rh factor is inherited is in the first place only among women who are afraid of a Rh conflict. For other parents, external data and the health of the unborn child are much more important. But it is worth noting that the characteristics of blood are no less important for a little man than hair color or eye shape, so you should familiarize yourself with the concept of Rh (Rh) and the principles of its inheritance.

Rh positive and negative

In humans, a group of lipoproteins can be on the surface of red blood cells, it occurs in about 85% of people, and in this case we are talking about the Rh-positive factor. But the absence of lipoproteins in 15% of children does not indicate a disease or developmental anomalies, but only indicates a negative Rh. The presence or absence of a lipoprotein group on an erythrocyte in most cases does not affect a person’s lifestyle in any way, only women with a negative Rh during pregnancy have a risk of an Rh conflict.

The lipoprotein formula has a rather complex composition, it will include various antigens, but the Latin D is used to denote the Rh factor:

"+" is denoted by D;
"-" put the letter d;

In this case, D is a dominant, and d is a recessive gene.

It would seem that D + d will always give a "+", but there are some nuances of the inheritance of the Rh factor, in which both Rh-positive parents give birth to Rh-negative children.

The mismatch of the Rh factor in parents and the child very often causes suspicions of treason and family quarrels, but in fact this is the norm and Rh-positive parents can give birth to Rh-negative children.

Why is this happening? To do this, we need to consider how parental genes are inherited and what a chromosome set is.

A little about genetics

Probably, many still remember from school that all cells of the human body, except for the cells of the reproductive system, consist of two chromosomes that carry dominant and recessive genes.

The egg and sperm have one chromosome set, and during fertilization, a new cell is formed that has a unique combination of chromosomes, which is responsible for external data and some features of the fetal body.

Rh, like other characteristics, is genetically transmitted, and the following combination may occur when the egg is fertilized:

As you can see, in the second case, the combination of Dd consists of a dominant and a recessive trait, that is, children are born with Rh "+", but they also have a recessive Rh "-" gene. Of course, at the level of genetic research, it is possible to identify which combination is available - DD or Dd, but this analysis is very complicated, it is not necessary.

For the presumptive determination of Rhesus by obstetricians, a table of inheritance is used.

Having considered how Rh is formed, it can be noted that a negative Rh in 100% of cases is inherited only from Rh-negative parents, in all other cases, the formation of both a negative and a positive Rh factor is possible. Moreover, the gender of the parent does not affect how Rh is inherited, inheritance depends only on the dominant gene.

A little about Rhesus conflict

Many women with Rh "-" are afraid to give birth to a man with Rh "+", fearing that they will not be able to bear and give birth to a healthy child. But this fear is not always justified.

Before dispelling most women's fears, it is worth considering how the Rhesus conflict proceeds:

the maternal organism, which does not have a lipoprotein component on the surface of erythrocytes, perceives the fetal lipoproteins as a foreign body;
the immune system of the pregnant woman begins to actively produce antibodies that destroy the erythrocytes of the embryo;
during this process, a large number of red blood cells die in the embryo, which leads to miscarriage or fading of pregnancy (fetal death).

The blood type and Rh of the fetus are formed by the end of the 3rd month of development, and it is at this time that a pregnant woman can lose her baby. But is there any hope for heterogeneous couples to have healthy children?

In fact, everything is not so scary and techniques have been developed that allow a woman to bear a full-fledged baby, even with a negative factor.

They include:

A specific vaccination that suppresses the reaction of the woman's immune system against foreign lipids. The vaccination can be done both before conception, when planning a pregnancy, and immediately after determining an interesting position.
Regular medical supervision. Such women have to take tests and visit antenatal clinics more often than other groups of pregnant women in order to timely identify the first deviations during pregnancy.

But only by the end of the 3rd month of gestation it will be possible to determine whether Rh “+” or Rh “-” is transmitted from the father. If a negative factor is detected in the fetus, then the pregnancy will proceed without the risk of embryo death due to the immune system of the pregnant woman.

Knowing about the inheritance of Rhesus helps to suggest the Rh factor of the baby even before his birth. But in most cases, this information plays an important role only in preventing Rh conflict in pregnant women.

Doctors were often puzzled by the death of patients after transfusions of seemingly ideally matched donated blood. It turned out that the reason for this was the Rh factor - a special protein, or rather, its absence.

In the blood of 85% of the entire population of the globe, this protein is present, and only 15% of people are deprived of it. The name was derived from the rhesus monkey whose blood was used in the experiments.

Rh factor protein is located on the surface of red blood cells -. It does not affect the state of human health, that is, in principle, both a child with the presence of this protein (with positive indicators) and with its absence (with negative indicators) is born healthy.

Problems can arise only when mixing different types of blood.

An organism that has blood with a positive Rh factor, getting blood even of a suitable group, but with a missing protein, is perceived as an alien attack. The activation of immunity begins to fight the "invader", and the so-called arises.

Reasons for the appearance or absence of a special protein in a child

The formation of the Rh factor in a baby is completely controlled by the laws of genetics. If both parents have a positive Rh factor, then a child can be born to them both with the same indicator and without it, that is, with a negative Rh factor. The same condition can appear if the mother has negative blood, and the father has positive blood.

If the fetus inherits the mother's blood, everything will be fine, but the appearance of a positive fetus in a negative mother threatens the development of an Rhesus conflict. If timely measures are not taken, the pregnancy may end in miscarriage, as the mother's body will perceive the fetus as a foreign body. However, if there is knowledge of a possible conflict, this happens extremely rarely, because the blood of the mother and fetus do not normally mix. Only in the presence of various pathologies, the entry of fetal cells into the mother's bloodstream can provoke a negative reaction in which the pregnant woman's body will try to expel the fetus.

Medical techniques make it possible to avoid such complications, to endure and give birth to a normal child.

In most cases, the mixing of the blood of mother and child occurs only at the time of birth and lasts a very short time.So that the baby does not develop hemolytic disease of the newborn, characteristic of the Rhesus conflict, it is immediately placed under special blue lamps.

This prevents the appearance of the negative influence of different blood.In the same case, if both parents are blood-negative, they cannot have a positive child in any way - there is simply nowhere for that very important protein to appear in his blood. So both parents with a negative Rhesus cannot become parents of a child positive for the factor. This is contrary to the laws of nature and our knowledge of human genetics.

A negative Rh factor in a child does not mean that he has any defects or developmental disorders. This is absolutely the same child as having positive blood. It's just that in his body there is no tiny component that will have to be taken into account in the process of his life and development.

Norm or pathology

A negative Rh factor in a child is not a pathology, it is a variant of the norm, characteristic of a certain part of the population. With the achievements of modern medicine, women with negative blood become mothers and give birth to healthy children, because the Rh conflict appears in less than half a percent of all cases.

Otherwise, this feature of the blood does not affect the general health of a person in any way - it is absolutely identical to people with a positive Rh, with the exception of a tiny protein.

You can learn more about what a blood type and Rh factor are from the video.