Gynecology And Obstetrics-

Blood group incompatibility during pregnancy

Synonyms

Rh intolerance, blood group intolerance

English: blood group incompatibility

definition

A blood group incompatibility between mother and child occurs during pregnancy if the child has features on its red blood cells (erythrocytes) that the mother does not have on hers. Most of the time this happens because of the so-called rhesus characteristic.

Rh intolerance

The constellation mother rhesus negative and fetus (unborn child) rhesus positive leads to the mother antibody (S. immune system) produced against the child's red blood cells. However, this only happens when maternal and child (fetal) blood have come into direct contact with one another. This contact occurs with every birth (i.e. also Miscarriage and Premature birth) when fixing a Ectopic pregnancy (see above) and when the placenta (placenta) resolves prematurely.

Note: blood group incompatibility

Since the newborn after the birth no longer comes into contact with the mother's blood and thus the antibodies formed, the first child who triggered the antibody formation in the mother is usually not harmed.

However, if the woman becomes pregnant again and lies down again Blood group intolerance before, these antibodies are still present in the maternal blood and are transmitted to the child through the placenta. These antibodies now destroy the child's red blood cells and lead to the so-called Haemolytic disease.

In the fetus, this process leads to fluid retention in the tissues and ascites. Swelling of the liver, heart and placenta is also possible (hydrops fetalis). In the newborn, an increase in red blood cells (erythroblastosis fetalis) and massive jaundice can then be observed. If uncertain, the diagnosis can be made by examining the maternal blood or the blood of the umbilical vein for antibodies.

If a low proportion of the red blood pigment is found in the fetus, a blood transfusion should be carried out in the womb. In general, an early delivery should be aimed for so that the fetus is no longer exposed to the maternal antibodies. If the blood values are still bad after that, a blood exchange transfusion with rhesus-negative blood, which the antibodies cannot affect.

Info: Anti-D prophylaxis

As a prophylaxis, every rhesus-negative mother after a pregnancy with a rhesus-positive child should have a so-called Anti-D prophylaxis to get. This prevents antibodies from being formed in the mother, which could endanger a fetus if a new pregnancy occurs.

ABO intolerance

There is also one Blood group intolerance regarding the feature AB0which, however, occurs less often. Only the antibodies from carriers of the blood type 0 can pass the placenta and thus lead to complications. But these are also milder, as the antibody formation only occurs at a later point in time pregnancy he follows. Here too, jaundice is treated with phototherapy above a certain limit (light therapy) treated.