Miscarriage during the first pregnancy is Rh negative. What blood type can't have an abortion? Prevention and treatment of Rh conflict

Hello! Today I have a sad topic, inspired by a story from mom’s groups. The girl wrote about how doctors stubbornly persuaded her to have an abortion according to indications, and how she resisted. I wondered how to make the right decision if doctors insist on a forced interruption, and the woman has contraindications. For example, negative Rh factor.

This fall, only the lazy did not write about the church’s initiative to ban abortion. Among the arguments of opponents, the need to terminate pregnancy for medical reasons was in first place. Such an abortion is called “forced” and presupposes the presence of serious diagnoses in the fetus or mother (ectopic pregnancy, pathologies incompatible with life, threat to the life of the mother, etc.).

At the same time, everyone somehow forgot that for some women interruption is, in principle, contraindicated. For example, an abortion with a negative Rh factor in the mother’s blood very often leads to subsequent attempts to have a child ending in miscarriage or infertility.

After an abortion, it is especially difficult for the body of such women to recover, therefore, even if you have an unwanted pregnancy and do not have the Rh factor in your blood, think ten times about the consequences before making a final decision.

Causes of Rh conflict and ways to neutralize it

Problematic blood compatibility arises because the mother does not have an antigen (protein) on the surface of her red blood cells. Accordingly, if a child’s Rh factor is positive (and this happens in 50% of cases), the mother’s body perceives it as a foreign object and seeks to expel the fetus. Actually, this is why negative Rh factor is dangerous. True, if a woman is expecting a child for the first time, then the risk is still minimal.

Firstly, a reaction to the fact that the fetus may never develop a positive blood type (in half of the cases this is exactly the case). Secondly, by registering with an obstetrician-gynecologist on time (at 7–8 weeks) and regularly donating blood for the Rh factor, the expectant mother helps her pregnancy proceed correctly and safely.
The future dad will also have to undergo tests, especially if he does not know whether his blood type is positive or negative.

As soon as the woman’s research results reveal the presence of antibodies and, in particular, their growth, the expectant mother is prescribed anti-Rhesus immunoglobulin. This drug helps stabilize the condition of the fetus and the pregnant woman. It is administered to the mother throughout pregnancy and immediately after childbirth.

Second pregnancy and negative blood type

The situation is somewhat more complicated if the couple already has a child and the family has decided on a second baby, or if a woman with negative Rh has had a frozen pregnancy, miscarriage or abortion. It’s good if the mother knows that she was injected with anti-Rhesus immunoglobulin serum after childbirth or after surgery, then there is hope that no negative reactions will occur in the woman’s blood.

Otherwise, since the body is already familiar with foreign antibodies of the IgG type, the likelihood of problems with bearing a fetus increases very much. In this case, again, it is very important to see a doctor as soon as possible.

A woman should find out what an increase in antibody titers in the blood affects at the very first stage of pregnancy. A second pregnancy with Rh conflict between mother and fetus can be very difficult, including hospitalization for preservation and intrauterine blood transfusion to the child.

But here, too, doctors already have certain achievements. In addition to introducing serum, they also work to purify blood plasma and even “deceive” the mother’s overactive antibodies, distracting them from attacking the fetus.

Involuntary abortion and Rh factor

What to do if, for some (very, very serious!) reasons, a woman with a negative blood type is advised to terminate her pregnancy? In this case, only early abortion can minimize the consequences. This should happen before the formation of blood flow in the fetus, i.e., at a maximum of 7 weeks. At the same time, the woman must be fully aware that she may not be able to bear the child later.

It should be noted that a negative blood type is a contraindication only for surgical abortion. I did not find any information about the fact that if you have the Rh factor, you cannot have a vacuum or medical abortion. It is better to check with your doctor how safe such methods will be.

After the operation, the patient is given anti-Rhesus immunoglobulin to reduce the body's sensitivity to the effects of foreign cells. The drug must be administered within the first two hours after termination of pregnancy or within the first three days after surgery. This is the only way to reduce the threat to a woman’s future pregnancy.

And finally. I don’t know what serious reasons can force a woman to have an abortion and whether they are comparable to probable infertility. What could it be? Severe pathologies in the unborn child? High probability of death for mother or baby? I really don't know.

In general, the topic of abortion, even forced abortion, is quite controversial and controversial. Should they be banned? I think not. Is it necessary to tighten control over this procedure? Perhaps yes, but without fanaticism.

The main thing is that the last word in this matter remains exclusively with the woman. The task of doctors is to explain the consequences, competently lead to a decision, assess the risks, and not intimidate the patient for the sake of statistics, plans and other bureaucracy.

Well then, friends. It seems to me that I have covered the question of the possibility of abortion or pregnancy in case of Rh conflict in sufficient detail. I hope neither you nor your friends will encounter this problem.

Visit me more often, invite friends, join discussions in the comments. As always, my gratitude for the repost!

When pregnancy begins in a woman’s life, she has to take care of her health in the most serious way.

One of these factors that you have to pay attention to is the Rh factor, which is associated with the presence of a special protein on the surface of blood cells - red blood cells. Most people have this protein in their blood and are Rh positive.

What is a negative Rh factor in a woman?

However, about 15 percent of people do without this protein, as a result of which their blood is Rh negative. In itself, a positive or negative Rh factor is only an indicator of a physiological characteristic and is not associated with any threat to human health.

What are the risks of having a negative Rh factor during pregnancy?

But with the onset of pregnancy, the situation changes. Couples in which both partners have the same Rh factor do not have to worry. There is no particular reason for concern in a situation in which the mother’s blood has a positive and the father’s blood has a negative Rh factor. Due to the fact that the mother's blood is stronger, the child inherits positive Rh from her. In cases where the mother's blood is Rh negative and the father's blood is positive, an unsafe situation arises, because The risk of a child inheriting Rh from his father is quite high.

Signs of hemolysis in a blood test. Why is Rh conflict dangerous during pregnancy?

The result may be the occurrence of a Rh conflict, in which the mother’s body will perceive the presence of protein in the blood of the fetus as something foreign, and therefore strive in every possible way to reject it from her body. The consequence is the production of antibodies, which enter the child’s blood. destroy his blood cells. This process is given the name hemolysis.

Rhesus conflict between mother and child consequences

It is not difficult to understand that this phenomenon poses a serious threat to the health of the unborn child. Due to hemolysis, the fetal organs are filled with fluid, contrary to the norm. Even after the baby is born, these antibodies continue to act for some time, which in almost all cases leads to hemolytic disease of the newborn.

The likelihood of Rh conflict during the first pregnancy

The type of antibodies produced depends on whether the woman is pregnant for the first time or a second time. In the case of the first pregnancy, the antibodies produced are quite large, and therefore enter the child’s blood much less frequently than in the case of a second pregnancy, when they easily penetrate the blood through the umbilical cord. This pattern causes the phenomenon that during the first pregnancy, a difference in Rhesus results in a significantly lower risk and is less likely to cause an Rhesus conflict.

Can there be a miscarriage due to Rh conflict?

Mismatch of Rh factors becomes a common cause of pregnancy failure, in the form of miscarriages or miscarriage.

How is Rh conflict diagnosed?

Since the condition of the expectant mother does not worsen due to Rh conflict, it is impossible to determine its presence “by eye” in the pregnant woman’s body. This task is perfectly accomplished by ultrasound, which detects an increase in the size of the internal organs, the presence of a large amount of fluid in them, due to which the fetus is not able to take its natural position, and is in a position with its legs spread out, called the Buddha position.

Is an anti-Rhesus immunoglobulin injection given during pregnancy?

Testing the expectant mother's blood for the presence of antibodies is also one of the reliable ways to detect Rh conflict. Prevention against the appearance of antibodies in a pregnant woman’s body can be the introduction of immunoglobulin into her body.

In a responsible and balanced approach to planning pregnancy and childbirth, future parents need to take into account not only the health of their bodies, but also many factors that can affect the health of the unborn baby. One of these factors is incompatible blood groups of future parents.

In medicine, the following are distinguished:

1 blood group – 0 (I).
– A (II).
– B (III).
– AB (IV).

Depending on whether the antigen, best known as , is present or absent on the surface of red blood cells, the blood can be either Rh positive (Rh+) or Rh negative (Rh-).

A person's blood type is a constant characteristic. It is determined by genetic laws and does not change under the influence of external factors. perhaps as early as the third month of intrauterine development.

As a rule, most doctors deny the fact that future parents have incompatible blood groups for conceiving a child. A woman’s inability to fertilize, carry a pregnancy and give birth to a healthy baby is more due to the immunological and genetic incompatibility of a man and a woman, as well as the production of sperm by the female body against the partner’s sperm.

Parents' blood groups for pregnancy may be incompatible due to the Rh factor. This factor should never be neglected in matters of pregnancy planning.

For conception, the Rhesus antigen has no significance. It also does not affect the development and bearing of the baby if a woman is pregnant for the first time or if she and her husband have Rhesus - positive blood type.

Only in the case when the father of the unborn child is Rh positive, this can lead to incompatibility of the blood groups of the mother and the pregnant child, and, as a result, to the development of such a life-threatening condition for the baby as an isoimmune conflict for the Rh factor , better known as during pregnancy.

Conflict during pregnancy arises because the mother’s Rh-negative blood reacts to the red blood cells of the developing baby, on the membranes of which specific proteins are present, as if they were a foreign organism. As a result, the female body begins to actively produce antibodies directed against the fetus.

The consequences of Rh conflict for a pregnant woman can be irreversible and include:

in the threat of miscarriage in early pregnancy or premature birth;
in the formation of intraorgan edema in the fetus, which can lead to intrauterine growth retardation;
in the development of a hemolytic disease in a newborn, characterized by the destruction () of its red blood cells by maternal blood cells, which continues to circulate in the child’s body for some time after birth.

For the woman herself, the development of an autoimmune conflict does not pose any danger. She will feel well even if the developing fetus begins to suffer in utero.

Therefore, it is extremely important for pregnant women who have had antibodies in their blood using a Coombs test to strictly follow all the recommendations of the doctor monitoring the development of pregnancy, promptly donate blood for examination and not neglect an ultrasound examination, since this will help identify the appearance of edema in the baby and the onset of development. hemolytic disease.

Are there always complications?

If a woman with Rh negative factor becomes pregnant for the first time in her life, there are still no specific antibodies in her blood. Therefore, the pregnancy will proceed completely normally, and there will be no threat to the health and life of the unborn baby. Immediately after giving birth, she will be given anti-Rhesus D serum, which will help stop the formation of these antibodies.

In addition, since antibodies in the blood of a Rh-negative woman do not disappear over time, but on the contrary, their number only increases with each subsequent pregnancy, the administration of this serum is indicated after each pregnancy, regardless of how it ends (childbirth, spontaneous or drug-induced abortion).

If a woman with a negative Rh factor already has antibodies in her blood, the administration of serum is strictly contraindicated.

Types of conflicts

There is also the concept of incompatible blood groups during pregnancy in mother and child, which can also lead to the development of conflict, but according to the ABO system.

This type of complication is as common as Rhesus incompatibility, but its consequences are less catastrophic. It can develop if the mother, that is, does not contain agglutinogens, and the child inherits any other group from the father, and accordingly his blood contains antigens A and B, both separately and together.

A conflict in the ABO system can develop even during the first pregnancy, but the fetus will not develop pathological conditions, and there will be no signs of anemia. But just as in the case of Rh-conflict, in the first days after birth the level of bilirubin in the child’s blood will be significantly increased and in order to eliminate the manifestations of pathological jaundice in him it will be necessary to carry out the same therapeutic measures as in the case of an isoimmune conflict for Rh- factor.

The blood groups of the child and the mother may also be incompatible for the birth of a child if the expectant mother has a history of a disease such as thrombocytopenia, that is, a decrease in the number of platelets in her blood. In this case, the woman experiences the formation of antibodies directed against the platelets of the fetus.

Conclusion

When making an initial visit to the antenatal clinic, the expectant mother will initially receive a referral to donate blood to determine her blood type and Rhesus affiliation. In the case of Rh(-) factor, her husband will receive the same direction. If the Rh factors of the future parents coincide, there will be no development of an autoimmune conflict.

In the case of different Rh factors of the spouses, the pregnancy will proceed under close supervision by a gynecologist, in order to early determine signs of the development of Rh conflict during pregnancy between mother and fetus, as well as the increase in signs of hemolytic disease in the baby. If they are detected, the woman will need urgent hospitalization and specific treatment.

Under no circumstances should you be upset and refuse to become pregnant and give birth to a baby if, for one reason or another, the blood groups of the future parents are incompatible.

Subject to careful medical supervision of the development of pregnancy, compliance with all recommendations and prescriptions of the gynecologist, it is possible, if not avoided, then to minimize all the negative consequences caused by different blood types of future parents. We hope you learned what incompatible blood groups are for pregnancy.

The Rh factor is nothing more than a protein that is formed on the surface of red blood cells - erythrocytes. Most people have it, and they are called Rh positive, in other words, they have a positive Rh factor. However, about 15% of people do not have this protein. These are people with negative Rh factor.

Research into this phenomenon was first undertaken in the first half of the 20th century. Since then, knowledge about this issue has expanded significantly; doctors are able to take the necessary measures so that women with a negative Rh factor can have healthy children with the opposite Rh factor.

However abortions with negative Rh factor remain, for the most part, the same risky undertaking as before. Let's figure out what the reason is.

Let's start, as they say, from the stove.
If a woman with a negative Rh factor is expecting a child from a Rh negative man, then there is nothing to worry about: the baby will be a carrier of the Rh factor of the parents and there will be no Rh conflict. It seems that abortion in this case involves only ordinary risks.

If a woman has a negative Rh factor and a man is Rh positive, then the fetus may well inherit the father's Rh factor. In this case, it is customary to talk about Rh conflict.

The fact is that the body of a woman with Rh negative perceives the blood of a Rh positive child as a threat, something harmful and foreign. Antibodies begin to be produced in the mother’s blood, which seek to protect the woman’s immune system from “invasion.” It would seem like an ordinary thing, but these same antibodies penetrate through the placenta into the baby’s blood and lead an “attack” on his red blood cells, trying to “destroy the enemy.”

As a result of such “fights”, not only the woman, but also the child suffers. Sensing the loss of red blood cells, the baby's body strives to increase their production, as a result of which the liver and spleen increase in size many times over. However, the woman's immunity is stronger, and the fetus cannot withstand the attack. Blood cells die, oxygen starvation begins, and the brain is damaged.

Now doctors have learned to cope with this problem. An Rh-negative woman with an Rh-positive fetus is carefully monitored, and if necessary, special procedures are prescribed in order to stop the “war” and continue the pregnancy until its natural end.

However, during childbirth there is a risk of the baby's blood getting into the Rh-negative mother's blood. If this happens, the body, albeit retroactively, will begin to produce antibodies to destroy foreign bodies.

Rh negative factor and abortion: risk of infertility

The same risk, amplified many times over, exists when carrying out. Moreover, it does not matter which type of artificial termination of pregnancy is to be performed. Whether it is a chemical, vacuum or classic abortion, even artificial birth, if the fetus is Rh positive, it will not pass without a trace.

And even this is not the main danger. The fact is that at the first meeting with foreign bodies of Rh-positive blood, the mother’s body produces a special kind of antibodies. They are quite large, inactive, and have difficulty penetrating the placenta. That is why the chances of carrying a first pregnancy with Rhesus conflict are extremely high, and women should never miss this opportunity.

But, be that as it may, the signal has been given, and during the next Rh-conflict pregnancy, the mother’s body will immediately receive information about the “harmful object” and “fighters” of a different kind will enter the “battle arena.”

Their task is the same - to destroy the “enemy”. But they are significantly different from their predecessors: they are smaller, very mobile and capable of delivering a fairly powerful blow to the baby’s “defense line”. Thus, each subsequent Rh-conflict pregnancy increases the risk of miscarriage or fetal development pathologies. The same goes for everyone abortion with negative Rh factor with a positive pregnancy.

Each case of pregnancy, abortion, miscarriage increases these risks by 10% in increasing order. Thus, with a sufficient number of abortions, at some point the onset of pregnancy becomes simply dangerous for the woman and has virtually no chance of ending successfully.

Negative Rh factor and abortion: safety measures

However, the decision to have an abortion is not always made by a woman on her own. There are situations when continuing pregnancy entails more dangers than abortion. In this case, a woman with negative Rh factor There's something else you should know.

Abortion with negative Rh factor may pass with minimal risk of sensitization (production of antibodies) if it occurs before the 7th week of pregnancy. The fact is that the fetus begins to produce foreign bodies for negative Rhesus by about 7–8 weeks from conception, which means that until this moment the mother’s body will not begin to produce antibodies in the event of contact with fetal blood.

After abortion with negative Rh factor Anti-Rh immunoglobulin must be administered - a substance obtained from donor blood that can stop the production of antibodies to proteins in Rh-positive blood.
This procedure is carried out from 2 hours to 3 days from the moment of termination of pregnancy. It is especially important in the case of abortion during the first pregnancy, as it can significantly reduce the risk of the next positive pregnancy.

Knowing this, if you still decide to abortion with negative Rh factor, choose a clinic with a good reputation and competent specialists who can provide you with a full range of measures to reduce the risk of complications, from choosing the type and timing of termination of pregnancy to the subsequent injection of the desired drug.

Alexandra Panyutina
Women's magazine JustLady

The news of pregnancy is not always joyful and desirable for women. There are insurmountable circumstances that force an early termination - an abortion. But, despite the possible health complications, you need to think several times and weigh all the factors before deciding on such an intervention. After all, termination of pregnancy is complicated not only by the risk of not getting pregnant or not carrying a child in the future, but also by a number of threats if a woman has a specific blood type (BG). So, what blood type should you not terminate your pregnancy?

News of pregnancy

The concept of Rh factor

Rhesus is a special protein substance that is attached to the cell membranes of red blood cells. It has antigenic properties. People who have this antigen in their blood are called “Rh-positive” (Rh (+)), and those lacking the protein substance are called “Rh-negative” (Rh (-)).

Such a division does not have much impact on people’s lives. Rhesus is taken into account in case of major bleeding, when the question of blood transfusion arises. There are six to seven times fewer Rh-negative people than Rh-positive people, so if a person has a rare GC (for example, IV), he will have to look for a donor.

In people who do not have the Rh antigen, immune protective reactions are expressed, for example: implant rejection occurs more often. Therefore, Rh (-) is of greatest importance for pregnant women whose fetus inherited Rh (+). This is dangerous due to sensitization (a pronounced response of the immune system to foreign irritants - allergens) of the female body, which mistakes the embryo for a foreign body.

A separate question is: is it possible to have an abortion with negative Rh? To answer it, you need to understand the essence of the Rh conflict and the danger of the consequences.

Rh negative and pregnancy

The main problem when a Rh-negative mother carries a Rh-positive child is the production of antibodies by the pregnant woman’s immune system against fetal antigens that have entered the blood. During the first pregnancy, the likelihood of mixing the blood of the baby and mother is minimal, which allows you to carry and give birth to your first child without complications.

But the first birth, abortion, miscarriage or placental abruption lead to the woman’s immunization with the baby’s red blood cells, which contributes to the body’s production of special antibodies, which in future pregnancies will attack the Rh-positive fetus, leading to sensitization.

Important! Sensitization that occurs against the background of Rh conflict is possible due to the immune memory of the cells, which has retained information about the first contact with the antigens of the embryo.

The onset of sensitization occurs unnoticed by the pregnant woman. This condition is determined by the content of antibodies in her blood (their titers), a large number of which indicates the severity of the pathological processes for the child. The degree of fetal damage is determined by ultrasound results. Sensitization leads to:

thickening of the placenta;
child's weight gain;
swelling;
an increase in the size of the heart and other organs, which leads to their dysfunction;
accumulation of fluid in the skull and abdominal cavity;
fetal hypoxia;
development of severe anemia;
the appearance of encephalopathy;
the occurrence of hemolytic disease.

Such consequences occur due to hemolysis (death) of red blood cells, which leads to severe intoxication of the fetus with decay products. Therefore, delay in taking appropriate measures is fraught with fetal acidosis (death inside the womb).

Rhesus conflict

From the above, it becomes clear what blood type you cannot have an abortion with. After all, if such consequences occur when Rh-negative women terminate pregnancy, then it’s worth weighing everything again.

Video on the topic:

Abortion: is it possible or not for Rhesus with a “-” sign?

People often ask: what blood type should you not have an abortion? It is not recommended for anyone (except for medical reasons), but the especially severe consequences depend not on the BG, but on the Rh factor.

But if the question is about the life or health of a woman, then it is better to terminate the pregnancy:

up to 8 weeks, since from this period the embryo begins to form hematopoiesis, and there is a high risk of its blood entering the mother’s blood during the procedure with further sensitization;
within 72 hours, the woman is given a dose of anti-Rhesus immunoglobulin, which inhibits the production of antibodies to suppress the positive Rh factor.

If the above conditions are met, there is still a possibility of sensitization in future pregnancies. Therefore, to the question of whether it is possible to have an abortion, each woman must answer herself, based on possible future complications.

Read also: – consequences that can cause Rh conflict

Methods of abortion

Several methods of abortion are used in medicine. They differ in the method of extracting the fertilized egg and the risk of complications:

The medical method involves taking pharmaceuticals that promote spontaneous rejection of the embryo. This type of abortion minimizes the likelihood of contact between the woman’s blood and the fetus, and is therefore considered the least dangerous. But this process is characterized by prolonged bleeding, similar in nature to menstruation. Abortion with the help of medications is possible only in the early stages - 4-6 weeks.
Mini-abortion is considered a non-surgical method. It is done using vacuum suction, which separates the fertilized egg from the uterine wall by suction. The use of the method is allowed for a period of 6-7 weeks, but it is also accompanied by bleeding for a week or more.
The surgical method is carried out by scraping the embryo from the uterine endometrium without visual control (blind). This is a dangerous method, as it does not guarantee complete extraction of the fertilized egg, is fraught with bleeding and significantly injures the walls of the uterus, which will make it difficult for the embryo to attach to the endometrium in future pregnancies. Therefore, such an abortion is carried out mainly at later stages, when other options are not applicable.

Important! All methods of abortion are associated with heavy bleeding, which increases anemia.

Even gentle methods of termination of pregnancy injure the uterine cervix, make the uterine endometrium thinner, which is fraught with perforation (perforation), and can lead to hormonal imbalances and various inflammations that take a chronic form. But most importantly, abortions lead to infertility.

In addition to the obvious dangers for women's health, abortion with such a Rh condition entails an increased risk of subsequent pregnancies, which is dangerous due to miscarriages, Rh conflicts, stillbirth, or the development of hemolytic pathologies in the child.

Danger to the fetus

Abortion - possible consequences

Abortions are especially dangerous if performed surgically in the later stages. But other options for termination, in addition to the complications listed earlier, lead to immunization of the woman with fetal blood cells. And this entails the production of anti-Rhesus antibodies by the expectant mother’s body, which penetrate into the blood of the child and attack his hematopoiesis during subsequent pregnancies.

The fact that pregnancy should not be terminated, especially for women with Rh (-), is evidenced by the following possible consequences in the future:

inability to get pregnant or frequent miscarriages;
probable deviations in the intrauterine development of the child due to sensitization (up to stillbirth);
perforation or damage to the uterine walls is possible, which leads to inflammation.

Abortion for an Rh negative woman

In any case, termination of pregnancy with Rh (-) does not go unpunished. Therefore, experts believe that in the absence of Rh antigen, abortion should be prohibited, except in cases of preserving the life and health of the woman.

Is it possible to have an abortion with low hemoglobin?

Most experienced doctors refuse to perform an abortion on a patient who has a low hemoglobin concentration. Carrying out such an operation can provoke the development of:

hypertension and heart failure;
swelling;
renal dysfunction;
intestinal infections and gastrointestinal diseases;
chronic fatigue and decreased immunity.

It can also negatively affect the health of future children.

Low hemoglobin and abortion

Before deciding on such a procedure, a woman should think carefully and weigh the pros and cons.