Pregnancy

Blood Mismatch During Pregnancy

Blood Mismatch During Pregnancy


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Blood Groups

According to the genetic characteristics of the person, more than 100 blood groups were defined. However, the main universally accepted blood groups identified in everyone are A, B, AB and O groups.

There are antigens that customize blood groups. The most important factor is Rh factor. It is essential to know the blood type of the mother during prenatal follow-up.

Each candidate should be asked to determine the blood type. If there is no Rh antigen in the blood Rh negative (-), If Rh antigen is present, Rh is defined as positive (+). More than 85% of people are Rh positive.

There is a blood mismatch in cases where the mother is Rh (-) (father who does not carry the Rh antigen) and the father is Rh (+).

What is Rh Conflict in Pregnancy?

When the mother is Rh (-) and the father is Rh (+), the baby's Rh status will be 50% or 100% Rh (+) depending on the genetic structure of the father.

In any case where the mother is Rh (-) and the father is Rh (+) (unless the child's blood type is determined for any other reason), it is generally considered to be the classic “blood mismatch” or “Rh mismatch”.

What can happen in the event of a blood mismatch?

If the mother Rh (-) and the baby Rh (+), even very small amounts of blood (0.1 ml) can pass from the fetus to the mother, the mother's immune system creates protective substances called antibodies against Rh proteins.

In this way, it cleanses the Rh proteins in its bloodstream. However, these antibodies have the ability to destroy the red blood cells when they enter the blood circulation of the Rh (+) fetus via the placenta and cord, which is the infant mate.

In this way, Rh sensitivity is developed in the mother and fetus. Directly proportional to the amount of antibody passed, the baby's mother's womb, anemia due to heart failure and death associated with it can be seen.

In What Conditions Does Rh Mismatch Affect Pregnancy?

The most important risk factor for the development of Rh susceptibility is the pregnancy of Rh (-) mother to give birth to Rh (+) infant and pregnancies without Rh hyperimmunglobulin.

Besides, from the baby risk of bleeding to the mother (fetomaternal) risk increases in the following cases;

  • Processes such as amniocentesis, CVS and cordocentesis
  • Haemorrhagic threat
  • Cases of placenta located in cervix (placenta previa) or early separation (placenta abruptio)
  • Blows to the abdomen
  • Multiple pregnancy
  • Cesarean section delivery

What Affects the Weight of Rh Mismatch in Pregnancy?

Red blood cells carrying fetal Rh antigen were 6.7%, 12-28 in the first 12 weeks of pregnancy. 16% in gestational weeks and 30% after 28th gestational week.

However, the rate of development of Rh sensitivity is less than 5%. The following factors are effective;

  • Fetal involvement is aggravated by the frequency and amount of fetomaternal bleeding.
  • Mother and baby between blood groups ABO mismatch In the presence of the table lighter course.
  • Rh phenotypic properties of fetal red blood cells
  • Baby gender
  • Genetic sensitivity

What Should I Do?

Your mother's immune system The most important protection principle is that this stimulation does not occur at all, since it produces irreversible antibodies against these foreign red blood cells once stimulated.

This stimulation is possible at the rate of 1% at first birth. However, every warning does not have to be due to birth. Wrong blood transfusion, blood-borne surgical instruments or interference with injections. blood incompatibility develop.
Therefore, every mother with Rh (-) is investigated by a simple test called indirect coombs for anti-Rh antibodies at the beginning of pregnancy.

The basic rule of not facing such a problem is protection.

  • Couple primarily before pregnancy blood groups should be determined.
  • If there is Rh incompatibility, the indirect coombs test should be repeated at 4-week intervals.
  • Early protection needle (300 microgram Rh hyperimmune globulin) can be given at 28 weeks of gestation.
If the baby's blood type is Rh positive after birth; injection of Rh hyperimmunglobin to prevent subsequent antibody production to protect infants Within 72 hours It was built. Hyperimmune globulin injection Sensitivity may develop in 0.4%.
  • If the expectant mother has become susceptible, the baby is at risk. Pregnancy antibody levels in the blood are checked regularly as it progresses. If it reaches high levels, the baby's health is perinatology clinic appropriate treatment should be followed. Pregnancies after Rh sensitization usually occur earlier than the affected pregnancy and a more severe course occurs.
  • In case of miscarriage, if the pregnancy is more than 3 months, full dose of immunoglobulin should be administered. In the first 3 months, a low dose of 50 micrograms of hyperimmunoglobulin (protective needle) is appropriate.
  • For medical reasons or optional abortion, Rh hyperimmunglobulin should be administered before the intervention.



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