You may ask: why the difference in the indicators of the Rhesus factors of future parents can turn into a problem? Because in this case it is not known whose baby the Rh will inherit and, most importantly, whether it will coincide with the mother’s one. If they are different, the woman’s body will perceive the child as a stranger and will start to fight with it, producing antibodies.
This is where the rhesus conflict itself arises, the extreme manifestation of which will be a hemolytic disease in a baby. What is going on?
When these antibodies get from the mother into the baby’s body, they will begin to destroy his red blood cells – red blood cells that deliver oxygen to all organs and tissues. If the lack of this important element becomes significant (obstetricians call this condition hypoxia), the child will feel uncomfortable and may experience developmental difficulties. At the same time, bilirubin is formed in the baby’s blood – a breakdown product of hemoglobin, which has a devastating effect on the functioning of the child’s body.
Hemolytic disease may take different forms, from mild to severe, it all depends on the amount of antibodies that the future mother’s body produces.
In order not to face the problem of Rh-conflict during pregnancy, all owners of a negative indicator need to remember this:
- it is desirable that the first pregnancy ended with the birth of a child;
- after each birth (no matter how long they began), as well as after the operation of abortion, the obstetrician must administer the antiresus immunoglobulin to the patient. This is very important because it helps to avoid problems in the future. By the way, when choosing a maternity hospital, all those interested should immediately find out if this medication is at the disposal of local doctors. If it turns out that they do not have it, you should buy the medicine yourself and take it with you when you go to give birth.
As we said, the purpose of this study is to obtain the amniotic fluid in which the baby swims (approximately 10–15 ml), and, having studied their composition, reliably judge its condition.
- Before the start of the manipulation, the doctor makes the future mother local anesthesia.
- The doctor inserts a special needle with a side cut to where, as shown by ultrasound, the greatest amount of amniotic fluid is detected and there is no danger of touching the umbilical loop, the placenta and the baby.
- Due to the fact that modern technology processes the information received very quickly, the result of the analysis will be ready immediately.
- After the procedure, the expectant mother spends about two hours in the clinic. During this time, the doctor must make sure that she feels good and that she is not disturbed by anything.
- Upon returning home, you should carefully listen to your feelings, especially in the first 48 hours after the procedure. If the expectant mother had pulling pains in the lower abdomen, the amniotic fluid began to leak, the baby began to worry, you need to urgently contact the doctor who performed the procedure, or go to the nearest hospital.
Fortunately, all these problems can appear only under a combination of certain conditions. For this, it is necessary that, firstly, a female should be the carrier of negative rhesus in a pair.
Secondly, the third participant of the events – the future baby – should inherit the positive rhesus of the father. And, finally, our heroine’s pregnancy should not be the first: the future mother’s organism will produce antibodies dangerous for the baby only from the second meeting with the “stimulus”.
That is why all owners of negative rhesus after the first pregnancy, whatever the end, need to introduce a special drug – antiresus immunoglobulin. But that’s not all: the combination of all these conditions does not mean at all that antibodies will surely appear in the blood of the future mother.
It all depends on how well her immune system works.
If the expectant mother has the risk of being in a situation of Rh-conflict, the obstetrician will suggest that she take a blood test once a month, which will help determine if there are any dangerous antibodies in her. By the way, in clinics that specialize in Rh problems, patients who do not detect antibodies in their blood are given antiresus immunoglobulin, which we discussed above.
It helps prevent their production in the near future.
If antibodies do appear, and in an amount that threatens the baby’s well-being, experts will decide to intervene. Especially if the patient already has children with a positive Rh factor and, after their birth, she was not given anti-Rhesun immunoglobulin.
In this situation, it will be important for the doctor to understand how the child feels, so he will refer the future mother to the ultrasound. If it turns out that the placenta of the baby has increased, as well as the tummy, and the amniotic fluid has increased, his mother will be assigned another study, which will give a more accurate result.
We are talking about amniocentesis – so called a small operation, through which you can take for analysis the amniotic fluid surrounding the child.
His results will show how much bilirubin is contained in them, which, by the way, can be judged by their color: they are normally almost transparent, under the influence of this substance they become yellowish or thick yellow in difficult cases. If there is too much bilirubin in the waters, the expectant mother will have another study, the most reliable, but at the same time the most difficult – cordocentesis. The doctor takes the baby’s umbilical cord blood for analysis, so it will be possible to determine its Rh factor and blood composition, that is, the content of deficient red blood cells in it.
If it turns out that the child needs help, the doctor will prescribe a treatment for him, which can begin as early as the 24th week of pregnancy. His goal is to alleviate the baby’s condition in order to prolong the pregnancy as long as possible, giving him the opportunity to “grow up” and have time to prepare for independent living. To do this, through the umbilical cord, using the same method of cordocentesis, a child is given a blood transfusion: the doctor injects him with a special drug – a concentrated solution rich in “purified” red blood cells, which compensate for the deficiency in the baby.
If necessary, this procedure will be repeated in 2–3 weeks.
Closer to the expected birthday of the child, the obstetrician will have to decide whether to bring this moment closer and how the child will be born. The answer to these questions depends on the well-being of the baby and the activity of the mother’s antibodies, and this can only be judged by obtaining the results of cordocentesis.
The purpose of this study is to take the blood of a future baby for analysis. The most accessible source of valuable material is the umbilical cord, which connects the child with the mother’s body.
- With the help of an ultrasound machine, an obstetrician and an ultrasound diagnostician determine which area of the umbilical cord is to insert a special needle through which the baby’s blood can be taken for analysis.
- By choosing this area, the doctor makes the future mother local anesthesia.
- Constantly checking the image on the monitor, he inserts a needle into the umbilical cord vein and takes the required amount of blood.
- The data about the Rh factor, the blood type of the baby and the composition of his blood, the doctor receives immediately.
- If during the examination the doctor only took the child’s blood for analysis, the expectant mother can go home within a few hours after the procedure. If the purpose of cordocentesis was blood transfusion to the baby, the woman will be asked to stay in the clinic for several days.
- As well as after the amniocentesis, the doctor will ask his patient to listen carefully to his feelings in the first 48 hours after the procedure. If the expectant mother thinks that contractions have begun, abdominal pains have begun, amniotic fluid has begun to leak, the baby is too active, you should immediately contact the doctor who performed the procedure or go to the nearest hospital.
Having received a referral to amnio and cordocentesis, parents wonder whether these studies are safe for the health of the mother and her baby. As you understand, we are talking about quite complex interventions. The risk of complications, although small, is still there, it is 0.2–0.5%.
On the other hand, let’s not forget that only a highly qualified doctor of a specialized clinic can conduct such procedures. With regard to the risk of hitting the baby, it is absolutely impossible, because in the first and second cases only the umbilical cord is the object of intervention.
In addition, the doctor does not act blindly, his efforts are controlled by the ultrasound machine.
Before starting the procedure, the doctor must tell the parents about what exactly the doctors will look for in the samples they are going to take. He should explain what consequences these procedures may entail.
Of course, parents have the right to abandon the study, which, fortunately, happens very rarely.