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– What does it mean when a person says – rhesus is positive or rhesus is negative?
– It is a violation of the rhesus factor of the blood group, which only poses a risk if a woman with a negative blood group carries fruit that inherited the positive blood group from her father. This happens up to 50 percent. cases, but certain complications occur in the woman and fetus during the second pregnancy. However, if the pregnancy is properly cared for and all necessary help is given, women successfully conceive a newborn and face no additional challenges.
In case of rhesus incompatibility, the woman should receive timely immunoprophylaxis by injection of immunoglobulin at 28 to 30 weeks’ gestation and after delivery.
A fetus is at risk if antibodies develop in a woman’s blood for a variety of reasons. This means that fetal blood containing rhesus factor positive entered the mother’s bloodstream. The mother’s immune system produces antibodies against fetal red blood cells. Antibodies from the mother’s blood, when they enter the fetal bloodstream, break down the fetal erythrocytes (red blood cells). While the fetus is still in the womb, anemia begins to develop. However, in the modern world of medicine, these types of situations are rare because all specialists who care for a woman are aware of the need for immunoprophylaxis.
There may also be a risk to the fetus if the woman has previously had a miscarriage or miscarriage, has not developed a pregnancy, or has had a normal pregnancy but has not undergone immunoprophylaxis.
If the fetal blood is negative for rhesus, like the mother, there will be no risk during pregnancy.
– How can modern medicine contribute to managing the dangers you have listed?
– If antibodies have already been detected in the blood of a woman with a negative blood type, immunoprophylaxis becomes ineffective because the fetus is already at increased risk of developing anemia. Then the task of doctors is to focus on the pregnant woman and diagnose fetal anemia in a timely manner.
This care does not cause additional discomfort to the woman since only non-invasive tests are performed. The woman undergoes an ultrasound to measure blood flow to the fetus. By measuring its cerebral blood flow, it is determined that the fetus does not show signs of anemia.
Another myth is that miscarriages do not lead to miscarriages. But there is no scientific evidence that miscarriage is associated with a rhesus factor mismatch.
If we see that the anemia progresses and the duration of the pregnancy is not long (the fetus is not yet premature), then we transfuse the blood while the fetus is still in the uterus. Fetal blood transfusions in Lithuania are performed in two perinatal centers (Kaunas and Vilnius). We are happy that this procedure is successfully performed in the Kaunas clinics and is able to produce healthy fruits.
If there are signs of fetal anemia in late pregnancy, we do not perform fetal blood transfusions in the uterus. After inducing labor and the blood transfusion procedure, we perform it after the birth of a baby.
– What should a woman know before planning a pregnancy if her blood type is negative?
– There is no additional preparation when planning a pregnancy. Like all pregnant women, she needs to drink folic acid to control her chronic disease.
If antibodies have been detected in a woman’s blood during a previous pregnancy, her subsequent pregnancies should be monitored at the perinatal center.
Photo from Fotolia / future mom
– What myths do you hear from patients about the rhesus factor mismatch?
– Now I hear myths very rarely. Women are very interested, they read and already know a lot of things for themselves.
Current options allow knowing the fetal blood type before it is born, which is why many women take advantage of this test.
But there are also fears: women think that if everything went well with the first pregnancy, the second will definitely have complications. However, if a woman receives timely help and her pregnancy is controlled accordingly, there should be no risk.
Another myth is that miscarriages do not lead to miscarriages. But there is no scientific evidence that miscarriage is associated with a rhesus factor mismatch. I have yet to hear that abnormalities in fetal development can occur, but there is no such scientific evidence either.
– Can all women with negative rhesus blood type go to clinics for testing or treatment?
– Perinatal care is well organized in Lithuania. Even in the smallest outpatient clinic, obstetricians and gynecologists know that in the event of an unsafe pregnancy, a woman must go to the perinatal center. Blood type and its rhesus factor are determined for each pregnant woman. According to the pregnancy care protocol, if a woman’s blood type is rhesus negative and an antibody titer is detected, indicating that there are already antibodies in the blood, the woman is referred to a perinatology center, like the Kaunas Clinic. After the pregnant woman’s exam, we assess her condition and prepare an additional care and delivery plan for the pregnant woman.
If no antibodies are detected in the blood of a woman, the woman is successfully cared for in a medical institution according to the place of residence. Obstetricians and gynecologists know that a woman needs immunoprophylaxis between 28 and 30 weeks: an injection of immunoglobulin. This service in Lithuania is free and available to all pregnant women.
In the treatment of immunoprophylaxis, very serious cases of rhesus non-compliance, requiring a transfusion of the unborn fetus, are very rare today.
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